brain drain issues essay

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Brain Drain Essay

100 Words Essay On Brain Drain

The term ‘Brain Drain’ is often used to refer to the emigration of highly educated or skilled individuals from one country to another. The loss of these individuals can have negative effects on the native country, including a shortage of qualified workers and deterioration of the quality of education and research. Brain drain can also lead to a brain gain for the receiving country, as it gains access to a larger pool of skilled workers. The most common reason for brain drain is the quest for better opportunities. Workers may leave their home countries in search of higher wages, better working conditions, or more prestigious positions.

200 Words Essay On Brain Drain

500 words essay on brain drain.

Brain drain is a problem that has been plaguing developing countries for years. It occurs when skilled and educated workers leave their home countries to seek better opportunities elsewhere. This often happens because these workers are not able to find good jobs at home, or because they are lured by higher salaries and better working conditions abroad. The problem of brain drain has been rapidly increasing in India, where many skilled workers have left to work in developed countries. This has had a devastating effect on the continent, as it has deprived India of the human resources it needs to develop its economy.

The loss of skilled workers can have serious consequences for a country's economy. When brain drain occurs, it can lead to shortages of qualified workers and a lack of innovation and creativity. This can ultimately hinder a country's ability to compete on the global stage. There are a number of ways to solve the problem of brain drain. One way is to provide better opportunities and jobs for skilled workers in India. Another way is to encourage the Indian diaspora to return home and share their skills and expertise with the people of their home countries and take part in the country’s holistic development.

There are many factors responsible for brain drain, but some of the most common include a lack of opportunities, poor working conditions, and low pay. When talented people are forced to leave their home countries in search of better opportunities elsewhere, it can have a detrimental effect on the country they leave behind. Not only does it deprive the country of their skills and knowledge, but it can also create a brain drain effect, where the best and brightest leave in search of greener pastures, leaving behind a less-qualified workforce.

Factors Responsible For Brain Drain

There are many factors causing brain drain. One of the most common is a lack of opportunity in the home country. When people feel they can not find good jobs or advance their careers in their own countries, they often look elsewhere.

Other factors include political instability, violence, and poverty. In some cases, people may leave their countries because they do not feel safe living there. Additionally, many people who are highly educated and skilled may choose to leave because they can earn more money elsewhere.

Brain drain can also occur when there is a mismatch between the skills required for available jobs and the skills of the workforce. This often happens in developing countries where jobs are growing faster than the education system can keep up with. As a result, many qualified workers leave to find better opportunities elsewhere.

Brain drain can also be caused by political or economic instability in a worker's home country. If a country is undergoing civil unrest or economic turmoil, its citizens may choose to leave in search of stability elsewhere.

Some workers may also leave their home countries in order to escape discrimination or persecution based on factors such as race, religion, or sexual orientation.

Effects Of Brain Drain

When a country experiences brain drain, it is losing its best and brightest minds to other countries. This can have a number of negative effects on the country.

For one, brain drain can lead to a shortage of skilled workers in the country. This can make it difficult for businesses to find the talent they need to grow and prosper. Additionally, brain drain can make it difficult for the country to attract foreign investment.

Furthermore, brain drain can lead to a loss of social and cultural capital. When the best and brightest leave the country, they take with them their skills, knowledge, and experience. This can leave the country at a disadvantage compared to other nations.

Finally, brain drain can have political consequences. The departure of skilled workers can leave the country short-staffed in critical areas such as healthcare and education. Additionally, brain drain can lead to a loss of tax revenue for the government as skilled workers are often among the highest earners in society.

How To Combat Brain Drain | There are many ways to combat brain drain, but some of the most effective include investing in education and training, creating more opportunities for advancement, and providing better working conditions and compensation. By retaining its best and brightest citizens, a country can ensure that its workforce is qualified and able to meet the demands of the ever-changing global economy.

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Brain Drain Essay

Essay on Brain Drain

Brain Drain is defined as the emigration or migration of individuals of talents and skills from developing or under-developed countries to developed ones. It means impoverishment of intellectuals, professionals, and technical resources of one country and enriching another. It is also known as the mass departure of skillful resources from a country. It brings a potential economic decline to the nation. Brain Drain subjects to a vital threat before a country. This migration results in a great loss to the countries where they are born and educated. Higher education is one of the important reasons for permanent emigration.

We, at Vedantu, have provided the students with an essay on brain drain with two perspectives in mind. The first one is the concept of making the students understand what is brain drain and next, to make them develop their essay writing skills which are useful in several ways including the need to write essays for improving their writing skills, for making good answers in the exams, to help the students prepare better result for themselves by going through this process.

The term ‘Brain Drain’ was first used by the United Kingdom in 1960 when the skilled workforce started emigrating from the developing or under-developed countries to the developed countries (first world countries). It refers to the situation when highly qualified and trained people leave his/her own country to permanently settle down in other developed countries. It is also known as human capital flight. With the beginning of globalization, ideas, opinions, skills in the form of labor started being exchanged between the nations.

This concept of Brain Drain is a matter of serious concern for any nation because it takes off individuals from their homeland to another foreign land. Often people go abroad to pursue higher education and settle there because of better work and attractive pay packages. Talented, skilled, and experienced professionals migrate to other countries for better career prospects. They get attracted by better standards of living and quality of life, higher salaries, access to advanced technology, and more stable political conditions in the developed countries which lead to migration from less developed countries.

The factors for the rise of Brain Drain are also called Push and Pull factors. The Push factors are the factors connected to the country of origin and Pull factors are the factors connected with the country of destination.

Push Factors:

The basic facility is not congenial for research and education in the institutions.

Under-employment for thousands of engineering graduates, scientific and technical manpower waiting for respective assignments.

Political instability.

Poor quality of living.

Limited access to health care facilities.

Less economic opportunity.

Pull Factors:

Better Economic prospects.

Better Research facilities.

Employment Opportunities.

Relative Political Stability.

Modern Education System and a better chance of advancement.

There are Three Types of Brain Drain

Geographical Brain Drain: This refers to the emigration of highly skilled professionals to other developing countries in search of better-paying jobs. It creates a negative impact on the economic development of the homeland.

Organizational Brain Drain: This refers to the departure of experienced and talented individuals from one organization to another. This exodus can be very harmful to organizations.

Industrial Brain Drain: This refers to the movement of skilled and trained workers from one industry to another for a better salary. This causes a shortage of experienced workers in the industry from where they depart.

Overall, Brain Drain is a widespread phenomenon these days. Many developing and under-developed countries are suffering from the loss of talents and skilled professionals like India, Africa, and Arab countries. The governments and private firms should take some strict measures to control this by aiming towards a better and friendlier atmosphere. They should provide better working conditions, improve infrastructure in educational institutions, create more employment opportunities, increase salaries and develop rural places. Making laws and strictly implementing them should check discrimination and bias at workplaces. Incentives should be given to youngsters from going abroad in search of work. These action plans can solve the problem of Brain Drain.

10 facts on Brain Drain Essay

The Brain Drain is the migration of talented geniuses from their homeland to other countries in search of a better life and jobs.

It occurs when people go out and settle abroad for their jobs or for making careers.

People often go abroad for their higher studies and after having finished their studies, they settle over there and do not return to their homeland which also causes brain drain.

It is of vital concern especially for developing countries like India, where it can have negative effects.

Countries like India keep losing citizens who have the potential and talent to change the economic conditions of the country.

However, Brain Drain is a call for hope for the countries to which the people migrate for their jobs or studies.

The countries which receive the migrating people from the other countries benefit a lot from them.

The problem of brain drain can be easily solved by providing better working conditions, good pay, and other facilities in the home country to the people.

Political disturbances are amongst one the other causes of brain drain.

Brain Drain also occurs in some countries as a result of poor living conditions for the people which pushes them to migrate to other countries.

Study the different points related to brain drain and compile a good essay on this topic. Learn more about this topic and seek assistance from Vedantu to get the best words on paper. Score well by brilliantly scribing this essay in exams and competitions.

FAQs on Brain Drain Essay

1. What is Brain Drain?

Brain Drain is the mass departure of talented and skilled individuals from a developing or under-developed country to a developing country. The Brain drain in simple words is defined as the migration of personnel in search of a better standard of living, quality of life, higher salaries, access to advanced technology, and more stable political conditions in the different places of the world. It is a condition which is fairly not good for the developing countries as they tend to suffer a major loss due to this.

2. What are Push Factors?

Push Factors are factors that are associated with the country of origin. The push factors are factors that motivate a person to migrate from their country or the region of living to another country in search of better jobs and living. The push factors are often used in a negative connotation, as they often consist of problems, distressing situations, and political or economic failures, depicting the poor conditions of the country. Also, this is a situation of loss for the country.

3. What is Organizational Brain Drain?

Organizational Brain Drain refers to the departure of experienced and talented individuals from one organization to another. This is similar to the original concept of brain drain. The concept involves the shift of employees from one organization to the other due to various reasons which include the movement due to organizational issues like poor working conditions, low pays, unhealthy work environment, etc. due to which the organization faces a challenge in many ways like the building of poor reputation within the industry and the like.

4. How to Prevent Brain Drain?

There are a lot of ways in which both the companies and countries can stop the problem of brain dragon some of which include the following:

To prevent the problem of Brain Drain, the governments of developing and under-developed countries should take stern measures of providing better working conditions to the employees in the form of infrastructure, health, travel, and other such measures.

The government must try to create more employment opportunities in the country itself so the people do not need to move by bringing in projects, developments, etc.

The government must try stopping discrimination with the people in all forms be it in terms of discrimination on the basis of age, gender, culture, religion, and others and any bias among employees.

The government must also work on the development of rural places to generate employment opportunities in the rural areas of the country.

5. Where can I get an Essay on Brain Drain?

The students can easily get essays on brain drain from the website of Vedantu for free of cost. The students will also have the access to many more new concepts which will help them in understanding better the different topics that persist. Vedantu also helps the students by providing them with other study material and resources like sample papers, previous year’s question papers, and other important resources that will help them in preparing for the exam and writing better answers.

Essay on Brain Drain

Brain drain refers to the movement of highly skilled and educated people from one country to another, where they can work in better conditions and earn more money. People migrate due to the lack of opportunities in their home country. The brain drain reduces economic growth through the depletion of a source country’s human capital assets and, additionally, through loss of return on investment in education. It’s a serious problem that most developing countries like India are facing today. The essay on brain drain will help students to understand the reason behind brain drain and how this problem can be solved. Students can also check out the list of CBSE Essays to practise more essays on different topics and boost their essay writing skills.

500+ Words Essay on Brain Drain

The term “brain drain” refers to the international transfer of human capital resources, and it applies mainly to the migration of highly educated individuals from developing to developed countries. The term is generally used in a narrower sense. It relates more specifically to the migration of engineers, physicians, scientists, and other highly skilled professionals with university training, to developed countries. The brain drain is a serious constraint on the development of poor countries.

Reasons for Brain Drain in India

The major reason behind the brain drain is the lack of career opportunities, investment and lower salaries in home countries. The highly skilled people do not get proper exposure where they can showcase their skills. They don’t get the opportunity to grow higher. This happens because, in many private and government organisations, the managers sitting in higher positions give preference to their relatives and known people. Many times, the hiring team does not use the correct assessment process to recruit people. Moreover, the reservation and reserved quota in government jobs are the major reasons why youth lose interest in appearing in various competitive or government exams.

Brain drain also occurs when an employee loses interest in work. If he continues to do the same task for 5 to 6 years, he becomes saturated with work. He wants some new role and responsibility that excite him and challenges him to do the work. The change in work also sharpens their skills and significantly increases their income. The work culture and environment also play a major role in brain drain. If the work culture is not flexible and reliable, then people start thinking of leaving the organisation and moving to another. Many times office politics, blame games, overwork, no appreciation, and no rewards also compel a person to look for a better opportunity where his skills will be appreciated.

India has skilled and semi-skilled, employed and unemployed human resources. Low salaries and inefficient working conditions trigger the movement of people to countries with better living standards and facilities. There is a huge difference in terms of salary in developed, developing and underdeveloped countries. Most of the students who go abroad for higher studies do not return to India. After seeing the affluent life of foreign countries, they lose all interest in their own country. They get placed in good companies and start living a high-profile life.

How to Stop Brain Drain?

Talent in emerging economies is scarce, expensive, and hard to retain. But, for the balance of power and for the development of the world, it is very important to stop the phenomena of brain drain. This will help a particular country to use all local skilled citizens for development and proliferation. But to hold these skilled workers at their native places, it is also important to provide them with enough work opportunities and living facilities. For this purpose, developed nations should help developing countries with the necessary money and resources. So that each and every human on this planet can have a good standard of living and each and every nation can introduce itself as a developed nation.

Students must have found this essay on brain drain useful for improving their essay-writing skills. They can get the study material and the latest updates on CBSE/ICSE/State Board/Competitive Exams at BYJU’S.

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Essay on Brain Drain

Students are often asked to write an essay on Brain Drain in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Brain Drain

Introduction.

Brain drain refers to the migration of skilled professionals from their home country to another for better opportunities. It’s a global issue affecting many nations.

Causes of Brain Drain

Brain drain is caused by several factors including lack of opportunities, low wages, political instability, and poor living conditions in the home country.

Effects of Brain Drain

Brain drain leads to loss of skills and intellectual resources. It can slow down the development of a country and create imbalance in the global distribution of talent.

To combat brain drain, nations need to improve their living conditions, provide better opportunities and create a stable political environment.

Also check:

Paragraph on Brain Drain

250 Words Essay on Brain Drain

Brain drain refers to the emigration of highly skilled individuals from their home countries to foreign nations, often in search of better opportunities. It is a global phenomenon that affects both developed and developing countries, posing significant socio-economic implications.

The primary cause of brain drain is the quest for improved living conditions. Professionals migrate to countries offering better job prospects, higher wages, and enhanced life quality. Political instability, lack of research opportunities, and inadequate infrastructure in home countries further exacerbate this issue.

Impacts of Brain Drain

Brain drain has a dual impact. The host countries benefit from the influx of skilled professionals contributing to their economic growth. Conversely, the home countries suffer from a loss of human capital, leading to a potential decline in their development pace.

Counteracting Brain Drain

To counteract brain drain, it is crucial for countries to create conducive environments that encourage their citizens to stay. This includes ensuring political stability, offering competitive wages, and investing in research and infrastructure. Implementing policies that promote circular migration can also be beneficial, where emigrants return to their home countries, bringing back new skills and knowledge.

While brain drain poses challenges, it also presents opportunities for global knowledge exchange. The key lies in managing this phenomenon effectively, turning the potential loss into a gain for both home and host countries. This requires concerted efforts from governments, institutions, and individuals alike.

500 Words Essay on Brain Drain

Understanding the phenomenon of brain drain.

Brain Drain, also known as Human Capital Flight, is a phenomenon where skilled and educated individuals migrate from less developed or developing countries to developed nations in search of better opportunities. This migration, while offering personal growth for individuals, often leads to a significant loss for their home countries.

The Driving Forces of Brain Drain

The primary drivers of Brain Drain are socio-economic in nature. The quest for improved living conditions, higher wages, and better career prospects are some of the primary reasons why skilled professionals migrate. Political instability, lack of infrastructure, and limited research opportunities also contribute to this exodus.

The Impact of Brain Drain

The impact of Brain Drain is multifaceted, with both negative and positive outcomes. On the negative side, the departure of skilled professionals leads to a knowledge gap in the home country. It hampers the growth of industries and research, and can even affect the country’s economy.

However, there’s a positive side as well. The remittances sent back home by these professionals can contribute significantly to the home country’s economy. Moreover, if these professionals return home after gaining global exposure, they can bring back valuable skills and knowledge, contributing to the development of their home country.

Brain Drain vs Brain Gain

While Brain Drain is often viewed negatively, it’s important to consider the concept of Brain Gain. This refers to the influx of skilled professionals into a country, which can lead to significant economic and social benefits. Developed countries often experience Brain Gain, which contributes to their continued growth and development.

Addressing the Issue of Brain Drain

Addressing Brain Drain requires comprehensive strategies that focus on improving socio-economic conditions, political stability, and research opportunities in the home country. Governments should invest in education, research, and development, and create an environment that encourages innovation and entrepreneurship.

Moreover, strategies should be developed to attract back the expatriate professionals. For instance, the concept of “Brain Circulation”, where professionals work overseas for a period and then return home, can be promoted.

Brain Drain is a complex issue with both negative and positive impacts. While it can lead to a loss of valuable human capital for developing countries, it can also result in economic benefits through remittances and the return of skilled professionals. Addressing this issue requires a balanced approach that not only prevents the outflow of talent but also encourages their return. The key lies in transforming the Brain Drain into a Brain Gain, thus turning a potential loss into a win-win situation for all involved.

That’s it! I hope the essay helped you.

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Brain Drain [Sample Essays and Vocabulary]

Posted by David S. Wills | Feb 27, 2023 | Model Essays | 2

For today’s English lesson, we are going to look at the topic of “brain drain.” This is a phenomenon that occurs when lots of talented people move from developing countries to developed ones. It is an interesting topic with many issues to debate, so it is possible that you could encounter it in the IELTS writing test.

What is “brain drain” and how could it appear in IELTS?

According to the Cambridge Dictionary, “brain drain” means:

the situation in which large numbers of educated and very skilled people leave their own country to live and work in another one where pay and conditions are better ( source )

This is quite a big issue nowadays and it affects many parts of the world positively and negatively. As the world becomes more interconnected, it seems reasonable that it will continue to be a problem in the future.

This sort of topic is most likely to occur in the IELTS writing test and specifically in task 2. In fact, I’ll show you two sample answers below. You might also see a reading passage about “brain drain” in the reading test and I suppose it is theoretically possible that it could be the subject of section 4 of the listening test.

However, I cannot imagine that you would realistically see questions about this in any part of the IELTS speaking test. It is slightly too specialised and talking about it is a little too difficult.

Language related to “brain drain”

When it comes to the topic of “brain drain,” you should think of this generally as being a sub-topic of work , education , and immigration . Note that IELTS topics often overlap like this.

As such, to talk about this, you should be comfortable with vocabulary related to these areas and specifically the points at which they intersect. Here are some examples:

advanced economy
developed country
developing country
emigration / emigrant
immigration / immigrant
permanent residency
standard of living
tertiary education
tuition fees

Make sure that you know more than just the loose meaning of each word or phrase. It is important that you know precisely how to use them.

Also, I have tried not to include more common words like “abroad” but obviously you should be familiar with them and confident about how to use them.

You can read more about common IELTS topics here .

How to think of ideas about “brain drain”

Sometimes, IELTS questions can be difficult not just because of the language required but because of the topic. While some people have strong opinions about brain drain, others don’t. They simply can’t think of anything to say or worry that their ideas aren’t very developed.

For this reason, it is useful not just to learn vocabulary in preparation for your IELTS test, but also to learn ideas. You can do that in different ways:

reading articles
listening to podcasts
watching videos or documentaries
engaging in debates

I recently saw this very interesting YouTube video, which goes into detail about why brain drain hurts some countries and why it keeps happening.

I have a whole article about how to generate ideas for IELTS .

Sample Essays

Ok, now let’s look at some sample questions and answers. These are quite similar but the types of question are different and so I have written different answers.

Brain Drain Essay: Problems and Solutions

Here is our first question:

An increasing number of professionals, such as doctors and teachers, are leaving their own poorer countries to work in developed countries. What problems does this cause? What can be done to deal with this situation?

As you can see, this is a problems and solutions question . That means you need to firstly explain the problems caused by brain drain and then suggest some solutions.

Sample Answer

In the modern era, it is common for people to move around the world for various reasons, including immigration purposes. This sometimes results in people leaving a poor country to go to a richer one, in a phenomenon that is sometimes known as “brain drain.” This essay will look into the reasons for this and also suggest some solutions.

The allure of wealthy countries is naturally going to appeal to many people from poorer nations. They look to these places and see opportunities for themselves and their families, as well as clean environments and high-quality homes and goods. It is natural, then, that these people will aspire to leave their own country and move to a more developed one in the hope of a better life. They study hard and take every possible chance to give themselves a brighter future, and once they are able to emigrate, they leave their home country and travel to their new home. This is usually a positive step for them, but it tends to trap poor countries in a cycle of poverty.

Solving this problem is clearly not easy because it is a pretty natural phenomenon and people will always want to give themselves a better life. However, if there was a way to encourage doctors and other professionals to stay in their home nation, they could help to build it into a much more prosperous society, ultimately resulting in generations of educated people with no real desire to leave. Another option is for that nation to attempt to attract doctors and teachers from other countries as a way of filling the knowledge gap. This would not be easy, but again if it were achieved it would result in a strengthened nation that would no longer encourage its citizens to leave.

In conclusion, it is a natural occurrence that people want to move to cleaner, more developed places with safer streets and better standards of living, which is why educated people flee from poor nations. However, solving this problem will not be easy and may require some creative action by various governments.

Notes on the Answer

I have a simple but effective structure here:

In terms of language, I will note some useful phrases:

The allure of wealthy countries
see opportunities for themselves
high-quality homes and goods
take every possible chance
a brighter future
a cycle of poverty
a much more prosperous society
filling the knowledge gap
a natural occurrence

You will see that my solutions are not very definite but that’s because there are no easy solutions. Some students write things like “The government should pay doctors more money.” However, is this a realistic suggestion? If governments had unlimited money and could pay doctors more, they probably would. Therefore, use careful thinking and language skills to show reasonable ideas. Don’t worry about your suggestions being weakened by the admission that these ideas might not work. It is better to show that you are aware of this than to confidently make unreasonable suggestions.

Brain Drain Essay: Discuss Both Views

Here is our second question:

Some people believe that professionals, such as doctors and engineers, should be required to work in the country where they did their training. Others believe they should be free to work in another country if they wish. Discuss both these views and give your own opinion.

You can see that this is a “ discuss both views ” question, so it is a little different from the previous one. Also, I suppose it is technically possible that you could answer this without mentioning brain drain, but still the idea is clearly connected.

A small number of people think that highly trained professionals should be required to work in the same country where they did their training, but most people disagree with this. This essay will also disagree, suggesting that they should be free to work where they want.

To begin with, it is understandable that people might argue in favour of professionals working in the country where they trained because in some cases that country has paid for their training. Take, for example, a doctor who received medical training at the government’s expense in a relatively poor country. If they moved to another country, perhaps in order to earn a higher salary, then the government’s investment would have been wasted.

However, there are a few problems with that viewpoint. First of all, professionals of this nature usually pay for their own education, and so if they were required to stay in that country then it would be unfair. A lot of people invest in their education purely to gain the chance of moving to another country for a better life. Then, of course, there is the argument that all people should have some freedom of movement. Particularly in the case of highly trained professionals, who can bring value to different societies, it is beneficial to have them move around the world, sharing their skills and increasing diversity. Perhaps they ought to give something back to the society in which they were trained, but they should not be restricted by any law because that would be a violation of their fundamental rights.

In conclusion, people who have important skills should be free to move to other countries if they wish. They should not have a legal obligation to stay in the nation where they earned their skills, but perhaps for the sake of decency they might consider staying a short while and giving back to that society.

I have not used the phrase “brain drain” here but the essay is still about that because brain drain is what happens when these people leave their home countries in large numbers.

Note that I have discussed both views but sided with the “disagree” perspective. That means I have written a longer paragraph full of “disagree” ideas. I have also made my opinion clear throughout the whole essay, which is also essential. In the introduction , for example, my outline sentence puts my perspective across very clearly.

Here are some more useful words and phrases:

highly trained professionals
to earn a higher salary
the government’s investment
people invest in their education
freedom of movement
a violation of their fundamental rights
a legal obligation

Finally, note that in both these essays I avoided the trap of repeating the examples from the question. It is a common mistake that IELTS candidates see an example and assume it is the main idea of the question. In fact, you do not need to talk about doctors and engineers. You could talk about any professionals.

About The Author

David S. Wills

David S. Wills is the author of Scientologist! William S. Burroughs and the 'Weird Cult' and the founder/editor of Beatdom literary journal. He lives and works in rural Cambodia and loves to travel. He has worked as an IELTS tutor since 2010, has completed both TEFL and CELTA courses, and has a certificate from Cambridge for Teaching Writing. David has worked in many different countries, and for several years designed a writing course for the University of Worcester. In 2018, he wrote the popular IELTS handbook, Grammar for IELTS Writing and he has since written two other books about IELTS. His other IELTS website is called IELTS Teaching.

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I have some questions related to IELTS Writing in general and your essays. 1. Have you tried using chatGPT for IELTS Writing? What do you think the quality of the essays it can create and how do IELTS learners use it to improve their writing? 2. In your essays + The first essay – You use near future tense ‘be going to do sth’ in the first sentence of the first body paragraph. Could you explain to me why you use this tense in this sentence? + The second essay – Actually, I see some dictionary mark ‘To begin with’ or ‘To begin’ as an informal phrase. Is it also proper when used in IELTS Writing? – In the second body paragraph, I see you use ‘increasing diversity’ which makes me confused. Could you explain what does this phrase exactly mean? Thank a lot

1. I’ve tested it a few times. It’s fine but not perfect. I haven’t really looked into it as a means of learning to write essays. I know that other AI programmes are terrible at fixing grammar problems, but ChatGPT is a lot smarter, so it’s possible.

2. This is used to mean that something hypothetically does appeal to these people. I suppose it is a strange structure, but it’s quite common in English. It is like imagining a future state.

3. I don’t think “To begin with” is particularly informal.

4. It means that when people travel around, the diversity of the places they go to increases because they have more people from different places.

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Short Essay: Brain Drain

Brain drain, or the emigration of skilled and educated individuals from one country or region to another, typically for better pay or living conditions, is a multifaceted issue with significant implications for nations and their development. Writing a short essay on this topic requires a balanced exploration of its causes, effects, and possible mitigation strategies. Here’s a structured approach to help you draft a concise and informative essay on brain drain.

Table of Contents

Title and Introduction

Title: Choose a clear and direct title that encapsulates the essence of your essay, such as “Navigating the Challenges of Brain Drain: Impacts and Solutions.”

Introduction: Begin with a hook that grabs the reader’s attention. You could use a compelling statistic, a quote, or a rhetorical question. Provide a brief overview of brain drain, including who it affects and why it is a critical issue. Conclude the introduction with a thesis statement that outlines the main points you will cover, such as the reasons behind brain drain, its consequences, and potential policies to address it.

Exploring the Causes

Economic Factors: Discuss how disparities in wage levels, employment opportunities, and economic conditions motivate professionals to migrate. For instance, engineers, doctors, and academics often move from developing to developed countries in search of better financial rewards and career prospects.

Political and Social Factors: Examine how political instability, lack of freedom, or social tensions in a person’s home country contribute to brain drain. Issues such as discrimination, violence, or political persecution can force skilled individuals to seek environments where they feel safe and valued.

Educational and Professional Opportunities: Highlight the lure of advanced research facilities, higher education opportunities, and more sophisticated work environments available abroad.

Effects of Brain Drain

Impact on the Home Country: Discuss the negative effects on the countries losing talent, such as weakened economic potential, reduced healthcare quality, and slowed technological advancement. Emphasize the irony where countries invest in education only to see the benefits reaped elsewhere.

Impact on the Host Country: While brain drain is often beneficial for the host country (gaining skilled labor), it can also lead to over-saturation in certain fields, potentially increasing local unemployment or underemployment in the skilled sectors.

Global Perspective: Consider the global implications of brain drain, such as how it affects international relations, contributes to global inequality, or influences global innovation dynamics.

Solutions and Mitigation Strategies

Improving Local Conditions: Suggest ways home countries can retain talent, such as improving economic conditions, offering competitive wages, and ensuring political and social stability.

Bilateral Agreements and International Cooperation: Discuss how agreements between countries can facilitate more balanced exchanges of knowledge and skills, or how international laws and policies can be adapted to manage the flow of skilled workers more ethically.

Incentives and Opportunities: Propose specific incentives that countries could offer to encourage expatriates to return, such as tax benefits, research opportunities, or leadership positions in industry and academia.

Summarize the key points discussed in your essay, reinforcing the complexity of brain drain and the need for multifaceted solutions. End with a compelling closing thought or call to action, encouraging stakeholders to consider both local and global strategies to effectively address brain drain.

Brain Drain Essay Example #1

Brain drain, the phenomenon of highly skilled professionals emigrating from developing nations to seek better prospects in developed countries, remains a significant challenge that exacerbates global inequality. This essay explores the underlying causes of brain drain, its impacts on both sending and receiving countries, and proposes viable strategies to mitigate its adverse effects.

Economic disparity is a primary driver of brain drain. Professionals in developing countries often face limited career opportunities and lower wages compared to their counterparts in developed nations. For instance, a software engineer in Silicon Valley can earn up to five times more than a similar professional in India. Political instability and lack of freedom also contribute significantly. Countries experiencing turmoil, such as Venezuela, see a mass exodus of skilled professionals seeking safety and stability. Additionally, higher education and advanced training opportunities in developed countries attract young talents who often choose to stay abroad after completing their studies.

The departure of skilled workers has a profound impact on their home countries. Economically, it leads to a loss of potential innovators and reduces the overall intellectual capital necessary for development and competitiveness. Socially, the healthcare and education sectors suffer when professionals like doctors and teachers emigrate, leading to diminished service quality. Conversely, host countries benefit from the influx of skilled labor, which can lead to technological advances and economic growth. However, this can also result in local discontent and increased competition in the job market, potentially fueling xenophobia or societal tension.

Addressing brain drain effectively requires a strategic and multifaceted approach. Home countries should focus on improving economic conditions through better governance and fostering a vibrant business environment that encourages entrepreneurship and investment. For example, Estonia has successfully retained and attracted talent through initiatives like e-residency and startup grants. Additionally, improving political stability and providing competitive wages and benefits can help retain skilled workers.

International cooperation is also crucial. Bilateral agreements can facilitate the ethical management of skilled migration, ensuring that both sending and receiving countries benefit. For instance, agreements could include clauses that encourage temporary migration for education or work, with clear pathways for individuals to return to their home countries, enriched with new skills and experiences.

Furthermore, creating opportunities for expatriates to contribute to their home countries without requiring permanent return can be effective. Programs that facilitate temporary teaching positions, remote consulting jobs, or investment in home-country enterprises can allow expatriates to contribute to their country’s development from abroad.

Brain drain is a complex issue influenced by economic, political, and educational factors. While it presents significant challenges for developing countries, it also offers an opportunity to rethink global and local policies. By improving domestic conditions and engaging in international cooperation, countries can mitigate the negative impacts of brain drain and turn it into a phenomenon that benefits all, promoting a more balanced global development. Strategic solutions that address both the causes and effects of brain drain will ensure that the migration of talent becomes part of a larger cycle of global knowledge sharing and development.

Brain Drain Essay Example #2

One of the primary drivers of brain drain is economic disparity. In many developing countries, professionals face limited career opportunities and lower wages compared to their counterparts in the developed world. For example, a software engineer working in Silicon Valley can earn significantly more than a similar professional in India. Political instability and lack of personal freedoms also play a crucial role. Countries experiencing political turmoil, such as Venezuela, witness a significant outflow of skilled professionals who seek safety and stability abroad. Moreover, the allure of higher education and advanced training opportunities in developed countries often entices young talents, who frequently choose to remain abroad post-graduation.

The effects of brain drain are profoundly felt by the home countries. Economically, the departure of skilled workers leads to a loss of potential innovators, diminishing the intellectual capital necessary for development and competitiveness. Social impacts are also significant, particularly in the healthcare and education sectors, which suffer from a lack of qualified professionals. In contrast, host countries typically benefit from the influx of skilled labor, experiencing technological advances and economic growth. However, this can also lead to increased competition in the job market, potentially fueling local discontent and societal tensions.

To effectively address brain drain, a strategic and multifaceted approach is required. Home countries need to focus on improving economic conditions through better governance and fostering a vibrant business environment that encourages entrepreneurship and investment. For instance, Estonia has successfully retained and attracted talent through innovative initiatives like e-residency and startup grants. Enhancing political stability and providing competitive wages and benefits are crucial to retaining skilled workers.

International cooperation plays a pivotal role in managing skilled migration ethically, ensuring mutual benefits for both sending and receiving countries. Bilateral agreements, for example, can facilitate temporary migrations for education or work, providing clear pathways for individuals to return to their home countries enriched with new skills and experiences.

Additionally, creating opportunities for expatriates to contribute to their home countries without requiring permanent returns can be effective. Programs that enable temporary teaching positions, remote consulting jobs, or investments in home-country enterprises allow expatriates to contribute to their country’s development from afar.

Brain drain is a complex issue, driven by economic, political, and educational factors. While it presents significant challenges for developing countries, it also provides an opportunity to rethink global and local policies. By improving domestic conditions and engaging in international cooperation, countries can mitigate the adverse effects of brain drain and transform it into a beneficial phenomenon that promotes balanced global development. Strategic solutions that address both the causes and effects of brain drain will ensure that the migration of talent becomes part of a larger cycle of global knowledge sharing and development.

Brain Drain Essay Example #3

Brain drain refers to the migration of skilled and educated individuals from less developed to more developed regions, seeking better opportunities and living conditions. This migration pattern poses significant challenges but also presents opportunities for strategic solutions to balance the scales of global development.

Economic disparity is a prime motivator for brain drain. Skilled professionals in less developed countries often encounter limited job opportunities and lower compensation compared to developed countries. For example, a software engineer in Silicon Valley can earn substantially more than their counterpart in many parts of Asia or Africa. Moreover, political instability and restricted freedoms compel individuals to seek environments where safety and rights are more assured. Educational opportunities also draw young talent abroad, where many remain after completing their studies due to better job prospects.

The departure of these skilled workers profoundly impacts their countries of origin. Economically, it leads to a drain of potential innovators and a reduction in the intellectual capital that is crucial for national development and competitiveness. The social impact is equally severe, especially in critical sectors like healthcare and education, which suffer due to the scarcity of qualified professionals. On the flip side, destination countries often benefit from the influx of skilled labor, which can drive technological innovation and economic growth. However, this can also stir local discontent and heighten job market competition, potentially leading to social tensions.

Addressing brain drain effectively requires comprehensive strategies. Countries of origin must improve economic conditions by enhancing governance and creating a business-friendly environment that encourages investment and entrepreneurship. For instance, initiatives similar to Estonia’s e-residency and startup grants have proven effective in retaining and attracting talent.

International collaboration is vital for managing skilled migration in a way that benefits both origin and destination countries. Bilateral agreements can help by enabling temporary migration for education or work, with clear incentives for return, enriching the home country with new skills and experiences.

Additionally, facilitating diaspora engagement can be a powerful tool. Programs that enable temporary teaching positions, remote consulting, or investment in local ventures allow expatriates to contribute to their home countries’ development remotely.

Brain drain is influenced by a mix of economic, political, and educational factors and presents substantial challenges for less developed countries. However, it also offers a chance to reform both global and local policies. By improving domestic conditions and fostering international cooperation, nations can mitigate the negative aspects of brain drain and transform it into a catalyst for global knowledge exchange and equitable development. This strategic approach ensures that talent migration contributes positively to global development, making the best use of the world’s human resources.

Final Writing Tips

Be Objective: Maintain a balanced view by discussing both sides of the issue.
Use Examples: Incorporate specific examples or case studies to illustrate your points more vividly.
Stay Concise: Keep your arguments focused and your writing clear, especially given the short essay format.
Proofread: Ensure your essay is free from grammatical errors and flows logically.

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The phenomenon of highly educated and skilled professionals moving from their home country to another country in search of better employment opportunities, living conditions, and other benefits is known as brain drain . This phenomenon presents several difficulties, including a sizable loss of human capital, a decline in the innovation and productivity of the source nation, and a potential imbalance in the distribution of talent globally.

Brain drain has become a major issue for many developing nations, as it results in the loss of talented people who could make significant contributions to the economic and social development of their home nations. Since a large number of highly skilled professionals have left Pakistan in search of better employment opportunities, the nation has struggled with a serious brain drain issue.

Causes of Brain Drain

The brain drain is caused by a number of factors. The absence of employment options in the country of origin is the main factor. It can be difficult for many highly qualified professionals to find employment that matches their education and experience, which causes them to look for opportunities elsewhere. Due to low pay and unfavorable working conditions in some countries, professionals may also struggle to support their families. Instability in politics, poor infrastructure, and limited access to technology can all be contributing factors.

The same is true for Pakistan, where one of the main reasons for the brain drain is a lack of economic opportunities. Many highly qualified professionals, such as doctors, engineers, and IT experts, are compelled to look for opportunities abroad because they cannot locate domestic jobs that match their skill sets. Similarly, long-standing political unrest in Pakistan has been characterized by frequent administration changes and a pattern of military takeovers.

Simultaneously, through their financial contributions, the diaspora communities—which include expatriates, overseas Pakistanis, and Pakistani Americans—have a significant impact on Pakistan’s economy. Whereas, doctors, engineers, scientists, and business owners are just a few of the highly qualified professionals living in the Pakistani diaspora. These professionals can help Pakistan develop by sharing their skills and knowledge because they have worked in developed nations where they have gained invaluable experience and knowledge.

Implications of Brain Drain

There are several detrimental effects of brain drain on developing nations. First, it leads to a shortage of highly skilled professionals, making it challenging to develop critical sectors such as healthcare, education, and technology. An additional effect is a decrease in investment in education and training. Secondly, governments invest a lot of money in professional development and education, and when these people leave the workforce, that investment is lost. Third, a reduction in innovation, research, and development may result from brain drain. It can also worsen economic inequality because most highly skilled and educated individuals can afford to emigrate.

Moreover, brain drain has serious repercussions for the country of origin. Highly skilled individuals frequently leave the country, resulting in a sizable loss of human capital that can harm the nation’s economic development. Sectors like healthcare, education, and research—which demand highly skilled personnel—feel the impact of this loss most acutely. Furthermore weakening the nation’s economy is the possibility of brain drain causing a general decline in productivity and innovation. Additionally, the exodus of talented people can make already-existing social and economic disparities worse by depriving the country’s marginalized communities of qualified professionals who can assist in meeting their needs.

Possible Solutions for Brain Drain

The issue of brain drain has been addressed with a number of solutions. In-country wage increases and better working conditions are two potential solutions. This may attract highly qualified professionals and persuade them to remain and support the growth of their nation. Making investments in vital industries like healthcare, education, and technology is an additional solution. Whereas, governments can foster an environment where professionals are more likely to stay and contribute to the growth of their nation by offering more employment opportunities and better infrastructure. A further way to entice professionals to stay in the country is by providing incentives like tax breaks and housing subsidies.

However, Pakistan must create a comprehensive strategy to address this issue that aims to retain its skilled workforce and draw in foreign investment. To provide training opportunities and help Pakistanis develop industry-specific skills, one potential solution is to form partnerships with foreign institutions. With this strategy, education, and training can be of higher quality, increasing the employability of Pakistan’s skilled labor force.

Pakistan should also concentrate on improving the environment in which companies can operate. The government should offer incentives to foreign investors to set up their businesses in Pakistan, which will create more job opportunities for the local workforce. To create a stable and conducive environment for businesses to operate, the government should prioritize investments in vital sectors like infrastructure, healthcare, and education.

Raising the standard of living in Pakistan is another way to draw and keep skilled workers. This can be done by funding social welfare programs, enhancing the standard of healthcare, and making sure that people live in a safe and secure environment. With this strategy, Pakistan’s citizens and the wider world may have a more favorable impression of the country.

The development of many developing nations is seriously threatened by brain drain. Some of the main reasons include a lack of job opportunities, low pay, unfavorable working conditions, poor infrastructure, limited access to technology, and political unrest. The detrimental effects of brain drain include a lack of highly skilled workers, a reduction in investments in education and training, a decline in innovation, research, and development, and a worsening of economic inequality.

However, there are potential solutions to these problems, such as enhancing working conditions and raising salaries, investing in important industries, and providing incentives like tax breaks and housing subsidies. Governments can improve the environment for professionals to stay and contribute to the growth of their nation by putting these solutions into practice, which will ultimately result in more economic and social advancement.

Last but not least, the loss of talent from Pakistan is a serious issue that hinders the development and growth of the economy in that nation. The main causes of this trend are the state of the global economy, unstable political conditions, and a weak educational system. By investing in education and training, fostering a more welcoming environment for businesses, and raising the general standard of living of its people, Pakistan can, however, position itself to attract and retain skilled workers in a fiercely competitive global marketplace.

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Essay of the Week: Brain drain in the developing world

Our band nine sample essays give you the opportunity to learn from successful essays that show off the best structure, vocabulary and grammar. This problem and solution type essay is about the complex issue of 'brain drain' in the developing world.

An increasing number of professionals like teachers and doctors are leaving poorer countries where they grew up to work in richer countries. What are some problems this causes and what are some solutions?

In recent years, developed countries have seen an influx of educators and healthcare practitioners from the developing world. In this essay, I will look at two issues this causes and present some solutions. First, that these countries do not recoup their investments in these people’s education, and second, that this leads to an unfair distribution of important workers.

First, professionals leaving the country after graduation is unfair to the countries who train them. When countries train public workers, they are making an investment in their education that they expect to recoup by having well trained staff in important jobs. If these professionals then leave the country for a high salary in the developed world, this means the country fails to get anything back for it’s investment. This is especially problematic for developing countries who have less public money available for education.

Second, this causes a shortage of professionals in those countries. Because these professionals have in-demand skills, it is easy for them to find jobs and visas abroad. This can cause staff shortages as poorer countries can lose staff to countries with more money causing a damaging shortage. For example, a country might lose teachers and then struggle to develop because of a lack of education provision.

To conclude, losing skilled professionals is both unfair and damaging to countries. However, there are several solutions to this problem. Developed countries should focus more on training their own workers rather than relying on the developing world. In addition, poorer countries should make training conditional on trainees working in that country for a period of time.

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Brain drain from developing countries: how can brain drain be converted into wisdom gain?

Brain drain is defined as the migration of health personnel in search of the better standard of living and quality of life, higher salaries, access to advanced technology and more stable political conditions in different places worldwide. This migration of health professionals for better opportunities, both within countries and across international borders, is of growing concern worldwide because of its impact on health systems in developing countries. Why do talented people leave their countries and go abroad? What are the consequences of such migrations especially on the educational sector? What policies can be adopted to stem such movements from developing countries to developed countries?

This article seeks to raise questions, identify key issues and provide solutions which would enable immigrant health professionals to share their knowledge, skills and innovative capacities and thereby enhancing the economic development of their countries.

INTRODUCTION

Brain drain is the migration of skilled human resources for trade, education, etc. 1 Trained health professionals are needed in every part of the world. However, better standards of living and quality of life, higher salaries, access to advanced technology and more stable political conditions in the developed countries attract talent from less developed areas. The majority of migration is from developing to developed countries. This is of growing concern worldwide because of its impact on the health systems in developing countries. These countries have invested in the education and training of young health professionals. This translates into a loss of considerable resources when these people migrate, with the direct benefit accruing to the recipient states who have not forked out the cost of educating them. The intellectuals of any country are some of the most expensive resources because of their training in terms of material cost and time, and most importantly, because of lost opportunity.

In 2000 almost 175 million people, or 2.9% of the world’s population, were living outside their country of birth for more than a year. Of these, about 65 million were economically active. 2 This form of migration has in the past involved many health professionals 3 : nurses and physicians have sought employment abroad for many reasons including high unemployment in their home country.

International migration first emerged as a major public health concern in the 1940s when many European professionals emigrated to the UK and USA. 4 In the 1970s, the World Health Organization (WHO) published a detailed 40-country study on the magnitude and flow of the health professionals. 5 According to this report, close to 90% of all migrating physicians, were moving to just five countries: Australia, Canada, Germany, UK and USA. 5

In 1972, about 6% of the world’s physicians (140 000) were located outside their countries of origin. Over three-quarters were found in only three countries: in order of magnitude, the USA, UK and Canada. 6 The main donor countries reflected colonial and linguistic ties, with a dominance of Asian countries: India, Pakistan and Sri Lanka. By linking the number of physicians per 10 000 population to gross domestic product (GDP) per capita , the countries that produced more physicians than they had the capacity to absorb were identified 7 as Egypt, India, Pakistan, Philippines and South Korea. However, the lack of reliable data and the difficulties of defining whether a migrant is ‘permanent’ or ‘temporary’ still exist.

One may claim that this migration from developing countries is both useful and unavoidable. There are definite advantages—enabling the migrant to spend time in other countries—but at the same time, the very low emigration rate of professionals from USA or UK may be as disturbing a sign as the high rates of immigration to these countries.

Young, well-educated, healthy individuals are most likely to migrate, especially in pursuit of higher education and economic improvement. 8 , 9 The distinction between ‘push’ and ‘pull’ factors has been recognized. 10 Continuing disparities in working conditions between richer and poorer countries offer a greater ‘pull’ towards the more developed countries. The role of governments and recruitment agencies in systematically encouraging the migration of health professionals increases the pull. 10 Migrant health professionals are faced with a combination of economic, social and psychological factors, and family choices 11 , and reflect the ‘push–pull’ nature of the choices underpinning these ‘journeys of hope’. De-motivating working conditions, coupled with low salaries, are set against the likelihood of prosperity for themselves and their families, work in well-equipped hospitals, and the opportunity for professional development. 12

In many cases, the country is not only losing its investment in the education of health professionals, but also the contribution of these workers to health care. For example, healthcare expenditure in India is 3% of GDP compared to 13% of GDP in the USA and the ratio of doctor to patients in India is 1:2083 compared to the USA where the ratio is 1:500. 13 Moreover, in many developing countries healthcare systems are suffering from years of underinvestment, which, for health professionals, has resulted in low wages, poor working conditions, a lack of leadership and very few incentives. 14

Employers in receiving countries take a different position; they have their own shortages of skilled people in specific fields and can drain a developing country of expertise by providing job opportunities. 15 Kupfer et al. provided the strategies to discourage migration to the USA, a major recipient country. 16 However, keeping the social, political and economic conditions in the developing countries in mind, can we stop the brain drain? Probably not!

Higher education is one of the principal conduits of permanent emigration. 17 The majority of doctors acquire specialized and postgraduate professional qualifications in the host country. Half of the foreign-born graduate students in France, UK and USA remain there after completing their studies. 18 Among the doctoral graduates in science and engineering in the USA in 1995, 79% of those from India and 88% from China remained in the USA. 19 The recent study on brain drain from 24 major countries published by the World Bank 20 also presented data on South Asian immigration to the USA ( Table 1 ). Migration to OECD (Organization for Economic Cooperation and Development) countries is also shown in Table 2 . Yet more data showing the momentum and demand for skilled people by high tech and research and development (R&D) industries illustrating accelerated flows of highly skilled workers to OECD countries are shown in Figure 1 .

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Employment of scientists and engineers with doctoral degrees in academia in the USA, 1973–1999. (Adopted from National Science Board. Science and engineering indicators, 2002 [ www.nsf.gov/sbe/srs/seind02/start.htm ])

Number of South Asian immigrants (age 25 and older) to the USA by level of educational attainment, 2000

Immigrants defined as foreign born population in the USA age 25 years or over. Primary education or less corresponds to 0-8 years of schooling; secondary to 9-12 years of schooling, and tertiary to more than 12 years of schooling [Source: A Study of 24 Labor-Exporting Countries . World Bank report, June 2003]

Stock of foreign students in OECD countries, 1998 (obtained from OECD 2002 [ http://www.oecd.org/home/ ]

OECD, Organization for Economic Corporation and Development

These statistics suggest that if developing countries provided world-class education and training opportunities, as well as opportunities for career advancement and employment, the migratory flow could be reduced. 21 However, in reality, this may not make much difference. On the plus side, foreign-born graduates acquire expensive skills which are not available within their countries. On the negative side, these skills and knowledge never migrate back to their own countries.

Besides the pull–push factors described earlier, some researchers from developing countries cite other reasons for not returning after training which include: lack of research funding; poor facilities; limited career structures; poor intellectual stimulation; threats of violence; and lack of good education for children in their home country. 20 Incentives for migrants to return to developing countries have been insufficient to override the limitations at home—both real and perceived—and the attraction of opportunities found abroad. Many of these countries have made significant investments in infrastructure and education but have not achieved the scientific development, technological and innovative capability either to retain or to recover the human capital that they have generated. Is there a solution to this problem? This raises the question of whether one can justify losing human capital or whether one should make the additional investment in science and technology and bring about the innovations that will stop the loss and convert it into wealth generation.

CONVERTING BRAIN DRAIN INTO WISDOM GAIN

Developing countries, especially South Asia, are now the main source of healthcare migration to developed countries. This trend has led to concerns that the outflow of healthcare professionals is adversely affecting the healthcare system in developing countries and, hence, the health of the population. As a result, decision-makers in source countries are searching for policy options to slow down and even reverse the outflow of healthcare professionals. Is it possible to do so? Maybe not, bearing in mind the current political and economic situations of the source countries and globalization. The increasing demand for health care in the higher income countries is fuelled to a large extent by demographic trends, e.g. the ageing of the baby-boom generation. 22

The opening up of international borders for goods and labour, a key strategy in the current liberal global economy, is accompanied by a linguistic shift from ‘human capital flight’ and ‘brain drain’ to ‘professional mobility’ or ‘brain circulation’. 22 Solutions should therefore be based on this wider perspective, interrelating health workforce imbalances between, but also within developing and developed countries.

At current levels, wage differentials between source and destination country are so large that small increases in healthcare wages in source countries are unlikely to affect significantly the supply of healthcare migrants. According to the results of a study in Pakistan, a small proportion of people funded for a doctorate face on return major nonfinancial disincentives for good performance. 23 Thus the financial component of such flows is only part of the picture and in some cases not the major push or pull factor. Moreover, there is a need to review the social, political, and economic reasons behind the exodus, and to provide security and opportunities for further development locally. Lowering of standards should not be accepted; instead local conditions should be reviewed and rectified.

CONTRIBUTIONS BY SHARING KNOWLEDGE AND SKILLS TO DEVELOPING COUNTRIES

It is time to understand and accept that health professionals’ mobility is part of life in the 21st century. Countries need to recognize that they compete with the best institutions in the world for quality manpower. It is time to bury the archaic concept of brain drain and turn to assessing the performance of health professionals and systems, wherever they are in the world. The turn of the 21st century has not only brought technology, but also modes by which scientists around the world can be connected in no time. In this globalized world the physical location of a person may or may not have any relation to the ability to make an impact on human health. Health professionals in the developed world may have most of their work portfolios in the developing world. Easy communication, quick travel, and greater collaborations between developed and developing countries are increasingly more common and we need to develop ways in which foreign professionals can contribute to their countries of origin.

Remittances from expatriates living abroad constitute a significant proportion of foreign revenue for many developing countries. 24 In Bangladesh for example US$ 2 billion is received from citizens who have emigrated overseas, and these remittances are the second largest source of foreign revenue. 25 The transfer and management of remittance revenues are potentially exploitable factors in plumbing the brain drain. Formalizing the transfer of remittances might permit the generation of revenues that could be invested nationally in the social and economic development of the developing home country. However, the magnitude and economic importance of remittances, economic development and growth, and ultimately social equity, depend on the endogenous capacity of each nation’s human resources. If only a small percentage of the multimillion dollar sums sent home by emigrants could be invested in research and development, might not opportunities for highly skilled and educated nationals improve at home? And would this not in turn spur economic development? Maybe to some extent—but without resources and skills, this may not have a huge impact on health and disease prevention.

It has been estimated that foreign scientists from developing countries who are involved in research and development produce 4.5 more publications and 10 times more patents than their counterparts at home. 26 Why is there such a vast difference in productive capacity? The context and conditions in which science and technology are able to prosper require political decisions, funding, infrastructure, technical support, and a scientific community; these are generally unavailable in developing countries. The value and effectiveness of individuals depends on their connection to the people, institutions and organizations that enable knowledge creation, and together constitute a propitious environment. These expatriate scientists and healthcare professionals can contribute their knowledge, clinical and research skills to their native countries by developing collaborative training programmes, research projects and teaching their own countrymen. This requires the commitment of foreign scientists and receptiveness at the other end. Scientists, political leaders and decision-makers in developing and developed countries, and international development agencies, need to appreciate the social and synergistic nature of knowledge sharing so that policies and education systems are designed to promote and enable research and development.

Healthcare services are a rapidly growing sector of the world economy and trade in health services has created diverse means of accessing these services across borders. For example, information technology can provide telemedicine services and telepreventive services. These information technologies can be used as a mode of sharing knowledge and research skills in a cost-effective manner.

One such large network is already in place called supercourse [ www.pitt.edu/∼super1 ] 27 which has connected more than 20 000 scientists, healthcare professionals and researchers together through IT connectivity, and they share their knowledge in the form of teaching lectures (currently there are more than 2000 lectures) for free to a global audience. A similar kind of connectivity needs to be developed by expatriate citizens who can contribute their knowledge and skills to their countries of origin without any major costs. Policies are needed to ensure that these favourable outcomes are realized as an equitable access to the benefits of the international trade in health services.

The availability of both high-quality education and opportunities in research are the keys to retaining and attracting regional talent. The steps taken by China towards becoming a leader in biological research and biotechnology illustrate the empowerment. The scientific leadership positioned China to become the only developing country participating in the Human Genome Project. 28 Experience gained through the participation of its institutions in the Human Genome Project (including large-scale sequencing, the use of bioinformatics and the coordination of multi-centre research protocols) provided the platform for developing biotechnology that can be applied to human diseases and agriculture. The opportunities generated by the Chinese in biotechnology attract both international collaboration in joint ventures and gifted scientists from China and abroad.

A similar example can be replicated in other developing countries with the help of their foreign expatriate citizens who have developed skills in research that are needed in their native countries. This approach to creating targeted educational opportunity together with political decision and investment in science and technology infrastructure provides a good example of a resourceful way of redirecting the brain drain. It is tempting to think that such on-site programmes involving national talent at home and abroad coupled with creative distance learning strategies could create networks of expatriates thus enabling their countries of origin to gain access to a world-class education in specific disciplines in the developing world.

Scientists who have emigrated for several reasons are recoverable assets who can play a part in developing opportunities at home. However, recovery requires the opening of diverse and creative conduits. The health services in the developing world must be supported to maintain their skilled personnel. Only when health staff, whatever their cadre, have the tools they require to do their job, training opportunities, a network of supportive colleagues, and recognition for the difficult job they do, are they likely to feel motivated to stay put when opportunity beckons from elsewhere. Foreign professionals could be used to develop innovative graduate education opportunities at home and technology to be transfered to areas of national priorities for research and development. Ultimately, involving individuals who are living abroad in creating opportunities at home favours both the retention and repatriation of national talent. Building an enlightened leadership and an enabling national scientific community, with the help of expatriate citizens, for the coherent development of scientific and technological capacity in developing countries will be mutually beneficial.

Acknowledgments

We are grateful to all Aga Khan University alumni at AKU Karachi, Pakistan and AKU USA for their valuable help.

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Brain Drain: The Great Indian Migration

Last updated on October 26, 2023 by ClearIAS Team

Table of Contents

What is Brain drain?

The brain drain is the migration of educated persons from one country to another.

Primary external brain drain occurs when human resources leave their country to go work overseas in developed countries such as Europe, North America, and Australia.

Secondary external brain drain occurs when human resources leave their country to go work elsewhere in the nearby region.

Internal brain drain occurs when human resources are not employed in the fields of their expertise in their own country or when human resources move from the public sector to the private sector or within a sector.

According to the recent information from the Ministry of Home Affairs (MHA) , more than six lakh Indians renounced their citizenship in the past five years. In 2021, till September 30 around 1,11,287 Indians have given up their citizenships.

In the past two decades, there has been a continuous outflow of Indians, except during the 2008 financial crisis and in 2020-21 due to Covid-19 related travel bans.

India has become a major exporter of healthcare workers to developed nations particularly to the Gulf Cooperation Council (GCC) countries, Europe, and other English-speaking countries. As per OECD data, around 69,000 Indian-trained doctors worked in the UK, US, Canada, and Australia in 2017. In these four countries, 56,000 Indian-trained nurses were working in the same year. Hence, there is also large-scale migration of health workers from India.

Why are Indians emigrating?

Indian competence, linguistic prowess, and a higher level of education are a few of the attractions for countries, which have eased visa rules to attract talent. As the opportunities become scarcer here, the foreign countries are ever more aware of the multi-talented Indian engineers, doctors, and scientists with English language prowess as well.

The reasons for this brain drain can be substantiated into a few key categories-

Push factors for brain drain:

Lack of higher education opportunities: The increasing cut-offs and legion of competitive exams make access to higher education difficult in India. Abroad, they have an advantage over students from other countries in terms of skills and knowledge.
Lack of financial research support: India’s Gross domestic expenditure on research has stayed at 0.7% of the GDP for years. India has one of the lowest GERD/GDP ratios among the BRICS nations. So, the minds in R&D tend to migrate to other countries to continue their research.
Lower-income: Developed countries offer better pay to sectors like health, research, IT, etc. Income is one of the main triggers of emigration from India.
Non-recognition of talents: The chances of being recognized in one’s field are difficult in a populace this large and with conventions preferring the glamour world over academic talent; bright minds choose foreign countries where their work is appreciated more.

Pull factors for brain drain:

Better standard of living: The developed countries provide better living standards, salaries, tax benefits, etc, which becomes a great attraction for emigration.
Improved quality of life: It is unarguable that the facilities available abroad are yet to be matched with by developing countries, and hence till that level of life quality is achieved, migrations will continue.
Societal pressure: Indian youth are becoming more liberal and personal with their life, and the society here is yet to come to terms with the kind of lifestyle. Hence, the pressure to live a certain way among the Indian society is curbing the freedom of choice of today’s youths, encouraging them to seek western countries where the society is more liberal non-interfering.
Easy migration policies : The developed nations are easing migration policies to attract talents to boost their economy. They target Asians specifically to take up intellectual labour.
Better remuneration: The better pay and living standard offered by developing countries is, of course, a foremost reason for emigration.

Also read: Refugee Crisis in India; Labor migration

The effect of brain drain on the Indian health sector:

The emigration of health workers from India to GCC and western countries has been taking place for decades. And this is part of the reason for the shortage of nurses and doctors.

As per government reports, India has 1.7 nurses per 1,000 population and a doctor to patient ratio of 1:1,404 which is well below the WHO norm of three nurses per 1,000 population and a doctor to patient ratio of 1:1,100.

There are strong pull factors associated with the migration of healthcare workers, in terms of higher pay and better opportunities in the destination countries.

But the push factors are what often drive these workers to migrate abroad.

In the case of nurses in India, the low wages in private sectors, along with reduced opportunities in the public sector plays a big role in them seeking employment opportunities outside the country.
The lack of government investment in healthcare and delayed appointments to public health institutions act as a catalyst for such migration.

Developed countries were in desperate need of retaining their healthcare workers, so they adopted migrant-friendly policies during the beginning of the pandemic.

OECD countries exempted health professionals from a job offer from the travel bans.
Some countries processed visa applications of healthcare workers even during the lockdown period.
The UK has granted free one-year visa extensions to eligible overseas healthcare workers and their dependents whose visas were due to expire before October this year.
France has offered citizenship to frontline immigrant healthcare workers during the pandemic.

The Indian government’s policies to check brain drain do not provide long-term solutions, rather they are restrictive.

In 2014, they stopped issuing No Objection to Return to India (NORI)certificates to doctors migrating to the US.
The NORI certificate is a US government requirement for doctors who migrate to America on a J1 visa and seek to extend their stay beyond three years.
The government has included nurses in the Emigration Check Required (ECR) category. This move was taken to bring about transparency in nursing recruitment and reduce the exploitation of nurses in the destination countries.

The need of the hour is for increased investment in healthcare which has been evident throughout the pandemic. The 2020 Human Development Report shows that India has five hospital beds per 10,000 people which is one of the lowest in the world.

Increased investment in healthcare, especially in the public sector is essential as this would increase employment opportunities for health workers.

Related concepts: Brain Gain and Reverse Brain Drain

There are few positive outcomes of such emigrations too occasionally which can be summarised under Brain gain and Reverse brain drain theories.

Brain Gain:

The movement of skilled workers internationally represents brain gain for the countries that reap their skills.
The young population that goes abroad has a very limited skill set. They improve their skills abroad through higher education and job experience, so when they return, they bring back brainpower. Some label it as Brain Circulation also.
Then the internal migrations of the skilled and unskilled lot have resulted in the formation of major industrial / tech hubs.

Reverse Brain Drain:

When the professionals return to their home country after a few years of experience and open a business, join a research university, or work in an MNC in the home country, it is called “Reverse Brain Drain”.
Reverse brain drain occurs when human capital moves in reverse order from a more developed country to a less developed or rapidly developing country.
These migrants accumulate savings, also known as remittances, and develop skills abroad and use them in their home country.
India has a large diaspora scattered around the world. Indian skilled professionals who have been trained and based in other countries are returning home in increasing numbers to take advantage of the country’s positive economic growth and employment opportunities in the STEM field.
Returnees with good work experience and entrepreneurial skills are setting up successful start-ups with the added advantage of their global networks and links to international venture capitals.

Government’s stance on Brain drain

India does not offer dual citizenship hence people seeking citizenship in other countries must give up their Indian passport. However, Indians who renounce citizenship can still apply for an Overseas Citizen of India (OCI) card, which gives them the benefit of residing and even running a business in India.

The Indian government has a simple online process for citizenship renouncing, making it clear that they are much worried about the outflow of the talented population.

A reason for this is maybe the fact that the expatriates have become huge financial assets for India through remittances and investments. NRI remittances have been a major contributor to India’s forex receipts though motivated by personal gains.

Some schemes have been devised by the government to bring back Indian scientists like-

‘The Ramanujan Fellowship, Innovation in Science Pursuit for Inspired Research (INSPIRE) Programme’ to encourage scientists and engineers of Indian origin from all over the world to take up scientific research positions in India, especially those scientists who want to return to India from abroad.
The Ramalingaswamy Fellowship , for providing a platform for scientists who are willing to return and work in India.
Vaishvik Bharatiya Vaigyanik (VAIBHAV) summit: Under this, Numerous overseas Indian-origin academicians and Indians participated to form ideas on innovative solutions to several challenges.
Scheme for Transformational and Advanced Research in Sciences (STARS), Scheme for Promotion of Academic and Research Collaboration (SPARC), and Impactful Policy Research in Social Science (IMPRESS) with the common objective to boost India-specific research in social and pure sciences.

Way forward

India needs systematic changes to build an overall environment that would be beneficial for the talented enough to motivate them to stay in the country.

The government should focus on framing policies that promote circular migration and return migration. Like policies that incentivize professionals to return home after the completion of their training or studies would be welcomed.

India could also hold talks to frame bilateral agreements for a policy of “brain-share” between the sending and receiving countries.

Potential Mains Questions:

“India’s brain drain is West’s brain gain.” Critically discuss why India’s scientists move to foreign countries and excel. Do you think brain drain is a thing of the past, especially in the field of science? Examine. (200 Words)
By emphasizing the key factors leading to brain drain in the health care sector deliberate the need for long-term solutions to manage human resources in the Indian health care sector. (250 words)

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Reader Interactions

February 16, 2022 at 11:34 am

In my opinion brain drain india is bad

November 15, 2022 at 10:08 pm

Atleast give information about migration of lawyer in brain drain. We lawyer are working really hard. Even our demand is there in foreign countries

January 3, 2024 at 10:04 am

According to me,Brain drain has to be stopped as it is not good for the development of our country.If skillful people don’t migrate then they can help in social and economic development of our nation and every country needs skilful people to do well in every field. so,I think Bharat needs to stop brain drain so that it can become “‘vishva guru'” soon.

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IELTS ESSAY: Solutions to the Brain Drain

Writing task 2: ielts essay: solutions to the brain drain..

You should spend 40 minutes on this task. Write about the following topic: An increasing number of professionals, such as doctors and teachers, are leaving their own poorer countries to work in developed countries. What are the reasons behind this trend? What solutions can you suggest to deal with this situation? Give reasons for your answer and include any relevant example from your own knowledge. Write at least 250 words.

Sample Answer:

Many developing countries in the world today are facing the issue of professionals migrating to other developed countries in search of better employment opportunities. This essay will help reflect on the causes of the situation and suggest possible ways to deal with this problem.

There are many reasons that have led to this scenario. The first and foremost one is the lack of professional opportunity in poor countries. increasing number of new graduates places pressure on the job market, which makes job-searching a very major task. Another factor behind this problem is salary. The income is not at par with the dedication and effort one puts in a job. Further, the working environment does not cater to the needs of the intellectuals. For these reasons, competent individuals prefer to leave their motherland and shift outside the country.

Taking into consideration all the causes, measures to stop brain draining can be constructively structured. The labor market needs to be expanded to create more job opportunities. Furthermore, extra pay or promotions can also help retain the talent. Lastly, it is important to construct a professional working environment which can help the skilful employees to develop their own capability.

Hence, it is pretty clear that there are obvious reasons encouraging the brain capital flight in developing countries. However, I understand that if proper steps are implemented, we will be able to tackle the problem and help solve it for a better future.

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Essay on Brain Drain for Children and Students

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Table of Contents

Brain Drain is the term used to state a significant emigration of educated and talented individuals. It occurs in countries such as India where the employment opportunities are not at par with the educated youth in the nation. Brain Drain is a slang used to describe a considerable emigration of highly educated and brilliant individuals. It is mainly an outcome of lack of good employment opportunities within a nation.

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Long and Short Essay on Brain Drain in English

Below we have provided short and long essay on brain drain of varying lengths in English for your information and knowledge and to help you with the topic whenever you required.

After going through the essays you will know what is brain drain; what are its impacts on the growth of a nation; what are the causes of brain drain; what steps had the government taken to prevent brain drain and what steps should be further taken by the government.

You can use these brain drain essay in your school/college events like speech giving, essay writing and debate etc.

Brain Drain Essay – 1 (200 words)

Migration of a significant number of educated and talented people from a country is referred to as Brain Drain. It occurs because of better job prospects in other countries as compared to one’s own country. Besides, brain drain may even occur at industrial or organizational levels when there is mass exodus from a company or industry as the other offers a better pay and other benefits. Brain Drain is a loss for the country, organization and industry as it takes away the most talented individuals of the lot.

The term, brain drain is often used to describe the emigration of scientists, doctors, engineers and other high profile professionals such as those in the banking and finance sector. Their emigration has a negative impact on their places of origin. In case of geographic brain drain, in addition to the loss of expertise, the consumer spending in the country also suffers immense loss. Hence, it can be a major loss for the country’s economy.

While the geographic brain drain occurs due to better financial prospects and standard of living in other countries, organizational brain drain may be caused due to various reasons including poor leadership, unreasonable work pressure, low salary package and lack of professional growth.

Brain Drain Essay – 2 (300 words)

Introduction.

Brain Drain refers to the mass departure of learned and talented people from a country, organization or industry. It causes a major problem for their place of origin as it suffers loss of talent that in turn impacts their economic condition. Many countries and organizations around the world are undergoing this grave issue due to various factors.

The Origin of the Term – Brain Drain

The term brain drain was sprint by the Royal Society. It was initially coined to refer to the mass departure of the scientists and technologists from the post-war Europe to North America. However, as per another source, this term first sprung up in the United Kingdom and it referred to the arrival of the Indian engineers and scientists. Brain waste and brain circulation are other similar terms.

Initially, the term referred to the technology workers immigrating to another nation however over the time it has become a general term used to describe the mass departure of talented and skilled individuals from one country, industry or organization to another in search of better paying jobs and higher standard of living.

Brain Drain a Common Phenomenon in Developing Countries

While certain first world counties such as UK have also experienced major brain drain, the phenomenon is more common in developing countries such as India and China. There are many factors that are responsible for brain drain in these countries. Higher salaries, better medical facilities, access to advanced technology, better standard of living and more stable political conditions are among few of the things that attract professionals towards the developed countries.

Several countries across the globe are facing the problem of brain drain and the government of these countries are taking certain measures to control the same however the problem still persists. Better plans need to be put in to place to control this issue.

Brain Drain Essay – 3 (400 words)

Brain Drain is a broad term used to describe mass migration of highly talented and skilled individuals from one country to another. The term is also used to refer to the mass departure of skilled professionals from one industry or organization to another to seek better pay and other benefits.

Types of Brain Drain

As mentioned above brain drain occurs at three levels – geographic, organizational and industrial. Here is a look at these different types of Brain Drain in detail:

Geographical Brain Drain

It is referred to the departure of highly brilliant and skilled individuals to another country in search of better paying jobs. It has a negative impact of their home country’s economy and overall development.

Organizational Brain Drain

The mass exodus of highly talented, skilled and creative employees from one organization to join another is referred to as organizational brain drain. It weakens the organization and toughens competition.

Industrial Brain Drain

It is the departure of employees from one industry in search of better jobs in other industries. It disturbs the working of the industries where brain drain occurs.

Factors Causing Brain Drain

There are different factors that cause brain drain at different levels. Though these factors are more or less the same, here is a look at these category wise:

Geographic Brain Drain

Here are the factors responsible for geographic brain drain:

Unstable political conditions of a country
Reservation system (in India) that denies good jobs to the deserving candidates and mostly provides high pay packages to the non-deserving ones
Low standard of living
Lack of good employment opportunities
Lack of good medical facilities

It generally occurs due to the following reasons:

Lack of good leadership and management in the organization
Low or no scope of growth
Pay packages lower than the market standards
Lack of fair play while giving promotions
No appreciation for work
Stringent working hours
Unreasonable work pressure
Relocation to a remote place also causes people to look for job elsewhere

Here are some of the top reasons for industrial brain drain:

Low salary package
Low growth prospects
Undue work load
Health hazards attached to certain industries

The factors responsible for brain drain have clearly identified. All that needs to done is to control these in order to overcome the issue. Among other things, there is a need to float better job opportunities in the market, offer pay packages at par with a person’s skill and create a healthy work environment to avoid this issue.

Brain Drain Essay – 4 (500 words)

Brain Drain, the process of talented individuals migrating from their home country to another in search of better job prospects and enhanced standard of living, is a growing problem these days. It is a loss for the country of origin as they lose out on talent that impacts their economy negatively. A number of countries across the world see a major pool of talent moving out each year.

Countries Suffering Brain Drain

While the third world countries suffer majorly from the issue of brain drain, developed countries are not safe either. Here is a look at the countries suffering major brain drain:

The United Kingdom

The United Kingdom that attracts numerous immigrants each year with its attractive pay packages and high standard of living also sees a major brain drain. Several individuals with University degrees have left UK, their country of origin, to seek jobs in other parts of the world.

The education system of India considered to quite strong and one that produces extremely talented and highly intelligent youth who in demand in every part of the world. Indians get good packages outside along with better standard of living and thus leave their country.

Greece has also included in the list of countries facing the brain drain problem lately. The debt crises explosion in 2008 led to a rapid increase in this issue. A majority of the people from Greece migrate to Germany each year.

Iran known for religious dictatorship and political oppression and this has led more than 4 million Iranians to migrate to other countries.

The civil war in Nigeria is one of the main reasons for Brain Drain in the country. A large number of Nigerians migrate to US each year in search of better job prospects and better standard of living.

Malaysia has also been facing the problem of Brain Drain mainly because its neighbouring country, Singapore offers better paying jobs there by sucking the former’s talent.

China, Ethiopia, Kenya, Mexico and Jamaica are among the other countries that suffer major brain drain.

Impact on the Place of Origin

Brain Drain is not only geographic, large number of talented individuals migrating from one organization to another or from one industry to another also known as Brain Drain. When a pool of highly talented and skilled individuals leaves their country, organization or industry and moves to another one in search of better prospects it is an obvious loss for their original place as the work at the later place suffers and so does its economic prosperity. In case of geographic brain drain, the immigration of doctors and engineers also has a negative impact on the society as a whole.

The countries and organizations facing major brain drain problem should analyze the factors responsible for the same and work upon improving the conditions to avoid this issue. It will help boost their place of origin economically.

Brain Drain Essay – 5 (600 words)

When a pool of learned and talented professionals especially doctors, engineers and those belonging to the financial sector leave their country of origin to seek better job opportunities in another country it known as Brain Drain. The problem is quite common in developing countries such as India. The mass exodus of employees from one company or industry to join the other also counted as Brain Drain.

India Suffers Major Brain Drain

Indians are making the country proud by excelling in different fields and securing highly paid jobs in different parts of the world. They are known to be brilliant in the fields of business and technology and there have been several reports stating that Indians form a major part of United State’s technology industry. Indians have thus contributed majorly towards building U.S. technology and in turn its economy. If they had contributed even half as much in the development of India, the country would have been in a better shape currently.

India suffers a major Brain Drain as the employment opportunities available here are not at par with the quality of education provided. Some of the other factors include the unfair reservation system, huge taxes and low standard of living.

Ways to Control Brain Drain

The geographic brain drain as well as that happening at organizational level is equally difficult to deal with. So why not avoid it in the first place. Here are a few ways to overcome the problem of geographic as well as organizational brain drain:

Do Away with the Quota System

In countries such as India, the talented lot suffer at the hands of the quota system. Many undeserving people from the reserved category secure highly paid jobs while the deserving candidates have to settle for lesser paying ones. It is but natural for such deserving individuals to seek job that is at par with their talent in a different country and shift base at the first opportunity they get. It is high time the government of India should do away with this biased quota system.

Let Merit be the Sole Decider

Apart from the quota system, people also preferred based on their creed, race and other things that have nothing to do with their talent when it comes to giving jobs. Many people have an inclination of giving jobs to those belonging to their own community or town. All this must stopped and a person must get job based on his merit and ability.

Fair Promotion

Many bosses have a liking for certain employees and a dislike for others. Often times it seen that even if an employee working hard and is doing a good job he still misses out on the promotion and the one who is the boss’ favourite get promoted even though he does not qualify in certain parameters. This causes dissatisfaction among the employees and they seek better opportunities outside.

Improve Leadership

It said that an employee does not leave the organization, he leaves his boss. Lack of good leaders and managers can cost the company a number of talented employees. People encouraged and rewarded for their work and if this does not happen at right time, they feel demotivated and look for opportunities outside.

Salary Packages

An organization must be fair when it comes to deciding salary packages. There should not be huge variation when it comes to salary packages of the employees working at the same level. Also, salary package must at par with market standards else employee will leave as soon as he gets a deserving package.

One of ways to uplift economy of developing countries such as India is to control problem of Brain Drain. Ways to control this problem such as ones mentioned here must taken seriously and implemented by government.

Brain Drain: a Persistent Issue in Developing Economies

Categories: Brain Drain

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Words: 451 |

Published: Sep 12, 2023

Words: 451 | Page: 1 | 3 min read

Dissecting the repercussions of brain drain, strategies to reverse or leverage brain drain.

World Bank. (2021). Leveraging Economic Migration for Development: A Briefing for the World Bank Board. World Bank.

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Health Effects of Vaping

At a glance.

Learn more about the health effects of vaping.

No tobacco products, including e-cigarettes, are safe.
Most e-cigarettes contain nicotine, which is highly addictive and is a health danger for pregnant people, developing fetuses, and youth. 1
Aerosol from e-cigarettes can also contain harmful and potentially harmful substances. These include cancer-causing chemicals and tiny particles that can be inhaled deep into lungs. 1
E-cigarettes should not be used by youth, young adults, or people who are pregnant. E-cigarettes may have the potential to benefit adults who smoke and are not pregnant if used as a complete substitute for all smoked tobacco products. 2 3 4
Scientists still have a lot to learn about the short- and long-term health effects of using e-cigarettes.

Most e-cigarettes, or vapes, contain nicotine, which has known adverse health effects. 1

Nicotine is highly addictive. 1
Nicotine is toxic to developing fetuses and is a health danger for pregnant people. 1
Acute nicotine exposure can be toxic. Children and adults have been poisoned by swallowing, breathing, or absorbing vaping liquid through their skin or eyes. More than 80% of calls to U.S. poison control centers for e-cigarettes are for children less than 5 years old. 5

Nicotine poses unique dangers to youth because their brains are still developing.

Nicotine can harm brain development which continues until about age 25. 1
Youth can start showing signs of nicotine addiction quickly, sometimes before the start of regular or daily use. 1
Using nicotine during adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control. 1
Adolescents who use nicotine may be at increased risk for future addiction to other drugs. 1 6
Youth who vape may also be more likely to smoke cigarettes in the future. 7 8 9 10 11 12

Other potential harms of e-cigarettes

E-cigarette aerosol can contain substances that can be harmful or potentially harmful to the body. These include: 1

Nicotine, a highly addictive chemical that can harm adolescent brain development
Cancer-causing chemicals
Heavy metals such as nickel, tin, and lead
Tiny particles that can be inhaled deep into the lungs
Volatile organic compounds
Flavorings such as diacetyl, a chemical linked to a serious lung disease. Some flavorings used in e-cigarettes may be safe to eat but not to inhale because the lungs process substances differently than the gut.

E-cigarette aerosol generally contains fewer harmful chemicals than the deadly mix of 7,000 chemicals in smoke from cigarettes. 7 13 14 However, this does not make e-cigarettes safe. Scientists are still learning about the immediate and long-term health effects of using e-cigarettes.

Dual use refers to the use of both e-cigarettes and regular cigarettes. Dual use is not an effective way to safeguard health. It may result in greater exposure to toxins and worse respiratory health outcomes than using either product alone. 2 3 4 15

Some people who use e-cigarettes have experienced seizures. Most reports to the Food and Drug Administration (FDA ) have involved youth or young adults. 16 17

E-cigarettes can cause unintended injuries. Defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious injuries. Most explosions happened when the batteries were being charged.

Anyone can report health or safety issues with tobacco products, including e-cigarettes, through the FDA Safety Reporting Portal .

Health effects of vaping for pregnant people

The use of any tobacco product, including e-cigarettes, is not safe during pregnancy. 1 14 Scientists are still learning about the health effects of vaping on pregnancy and pregnancy outcomes. Here's what we know now:

Most e-cigarettes, or vapes, contain nicotine—the addictive substance in cigarettes, cigars, and other tobacco products. 18
Nicotine is a health danger for pregnant people and is toxic to developing fetuses. 1 14
Nicotine can damage a fetus's developing brain and lungs. 13
E-cigarette use during pregnancy has been associated with low birth weight and pre-term birth. 19 20

Nicotine addiction and withdrawal

Nicotine is the main addictive substance in tobacco products, including e-cigarettes. With repeated use, a person's brain gets used to having nicotine. This can make them think they need nicotine just to feel okay. This is part of nicotine addiction.

Signs of nicotine addiction include craving nicotine, being unable to stop using it, and developing a tolerance (needing to use more to feel the same). Nicotine addiction can also affect relationships with family and friends and performance in school, at work, or other activities.

When someone addicted to nicotine stops using it, their body and brain have to adjust. This can result in temporary symptoms of nicotine withdrawal which may include:

Feeling irritable, jumpy, restless, or anxious
Feeling sad or down
Having trouble sleeping
Having a hard time concentrating
Feeling hungry
Craving nicotine

Withdrawal symptoms fade over time as the brain gets used to not having nicotine.

Nicotine addiction and mental health

Nicotine addiction can harm mental health and be a source of stress. 21 22 23 24 More research is needed to understand the connection between vaping and mental health, but studies show people who quit smoking cigarettes experience: 25

Lower levels of anxiety, depression, and stress
Improved positive mood and quality of life

Mental health is a growing concern among youth. 26 27 Youth vaping and cigarette use are associated with mental health symptoms such as depression. 22 28

The most common reason middle and high school students give for currently using e-cigarettes is, "I am feeling anxious, stressed, or depressed." 29 Nicotine addiction or withdrawal can contribute to these feelings or make them worse. Youth may use tobacco products to relieve their symptoms, which can lead to a cycle of nicotine addiction.

Empower Vape-Free Youth ad featuring a brain graphic and message about the connection between nicotine addiction and youth mental health.

U.S. Department of Health and Human Services. E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General . Centers for Disease Control and Prevention; 2016. Accessed Feb 14, 2024.
Goniewicz ML, Smith DM, Edwards KC, et al. Comparison of nicotine and toxicant exposure in users of electronic cigarettes and combustible cigarettes . JAMA Netw Open. 2018;1(8):e185937.
Reddy KP, Schwamm E, Kalkhoran S, et al. Respiratory symptom incidence among people using electronic cigarettes, combustible tobacco, or both . Am J Respir Crit Care Med. 2021;204(2):231–234.
Smith DM, Christensen C, van Bemmel D, et al. Exposure to nicotine and toxicants among dual users of tobacco cigarettes and e-cigarettes: Population Assessment of Tobacco and Health (PATH) Study, 2013-2014 . Nicotine Tob Res. 2021;23(5):790–797.
Tashakkori NA, Rostron BL, Christensen CH, Cullen KA. Notes from the field: e-cigarette–associated cases reported to poison centers — United States, April 1, 2022–March 31, 2023 . MMWR Morb Mortal Wkly Rep. 2023;72:694–695.
Yuan M, Cross SJ, Loughlin SE, Leslie FM. Nicotine and the adolescent brain . J Physiol. 2015;593(16):3397–3412.
National Academies of Sciences, Engineering, and Medicine. Public Health Consequences of E-Cigarettes . The National Academies Press; 2018.
Barrington-Trimis JL, Kong G, Leventhal AM, et al. E-cigarette use and subsequent smoking frequency among adolescents . Pediatrics. 2018;142(6):e20180486.
Barrington-Trimis JL, Urman R, Berhane K, et al. E-cigarettes and future cigarette use . Pediatrics. 2016;138(1):e20160379.
Bunnell RE, Agaku IT, Arrazola RA, et al. Intentions to smoke cigarettes among never-smoking US middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011-2013 . Nicotine Tob Res. 2015;17(2):228–235.
Soneji S, Barrington-Trimis JL, Wills TA, et al. Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: a systematic review and meta-analysis . JAMA Pediatr. 2017;171(8):788–797.
Sun R, Méndez D, Warner KE. Association of electronic cigarette use by U.S. adolescents with subsequent persistent cigarette smoking . JAMA Netw Open. 2023;6(3):e234885.
U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease . Centers for Disease Control and Prevention; 2010. Accessed Feb 13, 2024.
U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General . Centers for Disease Control and Prevention; 2014. Accessed Feb 12, 2024.
Mukerjee R, Hirschtick JL, LZ Arciniega, et al. ENDS, cigarettes, and respiratory illness: longitudinal associations among U.S. youth . AJPM. Published online Dec 2023.
Faulcon LM, Rudy S, Limpert J, Wang B, Murphy I. Adverse experience reports of seizures in youth and young adult electronic nicotine delivery systems users . J Adolesc Health . 2020;66(1):15–17.
U.S. Food and Drug Administration. E-cigarette: Safety Communication - Related to Seizures Reported Following E-cigarette Use, Particularly in Youth and Young Adults . U.S. Department of Health and Human Services; 2019. Accessed Feb 14, 2024.
Marynak KL, Gammon DG, Rogers T, et al. Sales of nicotine-containing electronic cigarette products: United States, 2015 . Am J Public Health . 2017;107(5):702-705.
Regan AK, Bombard JM, O'Hegarty MM, Smith RA, Tong VT. Adverse birth outcomes associated with prepregnancy and prenatal electronic cigarette use . Obstet Gynecol. 2021;138(1):85–94.
Regan AK, Pereira G. Patterns of combustible and electronic cigarette use during pregnancy and associated pregnancy outcomes . Sci Rep. 2021;11(1):13508.
Kutlu MG, Parikh V, Gould TJ. Nicotine addiction and psychiatric disorders . Int Rev Neurobiol. 2015;124:171–208.
Obisesan OH, Mirbolouk M, Osei AD, et al. Association between e-cigarette use and depression in the Behavioral Risk Factor Surveillance System, 2016-2017 . JAMA Netw Open. 2019;2(12):e1916800.
Prochaska JJ, Das S, Young-Wolff KC. Smoking, mental illness, and public health . Annu Rev Public Health. 2017;38:165–185.
Wootton RE, Richmond RC, Stuijfzand BG, et al. Evidence for causal effects of lifetime smoking on risk for depression and schizophrenia: a Mendelian randomisation study . Psychol Med. 2020;50(14):2435–2443.
Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P. Change in mental health after smoking cessation: systematic review and meta-analysis . BMJ. 2014;348:g1151.
Centers for Disease Control and Prevention.   Youth Risk Behavior Survey Data Summary & Trends Report: 2011–2021 . U.S. Department of Health and Human Services; 2023. Accessed Dec 15, 2023.
U.S. Department of Health and Human Services. Protecting Youth Mental Health: The U.S. Surgeon General's Advisory . Office of the Surgeon General; 2021. Accessed Jan 5, 2024.
Lechner WV, Janssen T, Kahler CW, Audrain-McGovern J, Leventhal AM. Bi-directional associations of electronic and combustible cigarette use onset patterns with depressive symptoms in adolescents . Prev Med. 2017;96:73–78.
Gentzke AS, Wang TW, Cornelius M, et al. Tobacco product use and associated factors among middle and high school students—National Youth Tobacco Survey, United States, 2021 . MMWR Surveill Summ. 2022;71(No. SS-5):1–29.

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By Steven Levy

AI Is a Black Box. Anthropic Figured Out a Way to Look Inside

Light trails moving inside of black box on pedestal in front of a blue backdrop

For the past decade, AI researcher Chris Olah has been obsessed with artificial neural networks. One question in particular engaged him, and has been the center of his work, first at Google Brain, then OpenAI, and today at AI startup Anthropic, where he is a cofounder. “What's going on inside of them?” he says. “We have these systems, we don't know what's going on. It seems crazy.”

That question has become a core concern now that generative AI has become ubiquitous. Large language models like ChatGPT , Gemini , and Anthropic’s own Claude have dazzled people with their language prowess and infuriated people with their tendency to make things up . Their potential to solve previously intractable problems enchants techno-optimists. But LLMs are strangers in our midst. Even the people who build them don’t know exactly how they work, and massive effort is required to create guardrails to prevent them from churning out bias, misinformation, and even blueprints for deadly chemical weapons. If the people building the models knew what happened inside these “black boxes,'' it would be easier to make them safer.

Olah believes that we’re on the path to this. He leads an Anthropic team that has peeked inside that black box. Essentially, they are trying to reverse engineer large language models to understand why they come up with specific outputs—and, according to a paper released today, they have made significant progress.

Maybe you’ve seen neuroscience studies that interpret MRI scans to identify whether a human brain is entertaining thoughts of a plane, a teddy bear, or a clock tower. Similarly, Anthropic has plunged into the digital tangle of the neural net of its LLM, Claude, and pinpointed which combinations of its crude artificial neurons evoke specific concepts, or “features.” The company’s researchers have identified the combination of artificial neurons that signify features as disparate as burritos, semicolons in programming code, and—very much to the larger goal of the research—deadly biological weapons. Work like this has potentially huge implications for AI safety: If you can figure out where danger lurks inside an LLM, you are presumably better equipped to stop it.

I met with Olah and three of his colleagues, among 18 Anthropic researchers on the “mechanistic interpretability” team. They explain that their approach treats artificial neurons like letters of Western alphabets, which don’t usually have meaning on their own but can be strung together sequentially to have meaning. “ C doesn’t usually mean something,” says Olah. “But car does.” Interpreting neural nets by that principle involves a technique called dictionary learning, which allows you to associate a combination of neurons that, when fired in unison, evoke a specific concept, referred to as a feature.

“It’s sort of a bewildering thing,” says Josh Batson, an Anthropic research scientist. “We’ve got on the order of 17 million different concepts [in an LLM], and they don't come out labeled for our understanding. So we just go look, when did that pattern show up?”

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Last year, the team began experimenting with a tiny model that uses only a single layer of neurons. (Sophisticated LLMs have dozens of layers.) The hope was that in the simplest possible setting they could discover patterns that designate features. They ran countless experiments with no success. “We tried a whole bunch of stuff, and nothing was working. It looked like a bunch of random garbage,” says Tom Henighan, a member of Anthropic’s technical staff. Then a run dubbed “Johnny”—each experiment was assigned a random name—began associating neural patterns with concepts that appeared in its outputs.

“Chris looked at it, and he was like, ‘Holy crap. This looks great,’” says Henighan, who was stunned as well. “I looked at it, and was like, ‘Oh, wow, wait, is this working?’”

Suddenly the researchers could identify the features a group of neurons were encoding. They could peer into the black box. Henighan says he identified the first five features he looked at. One group of neurons signified Russian texts. Another was associated with mathematical functions in the Python computer language. And so on.

Once they showed they could identify features in the tiny model, the researchers set about the hairier task of decoding a full-size LLM in the wild. They used Claude Sonnet, the medium-strength version of Anthropic’s three current models. That worked, too. One feature that stuck out to them was associated with the Golden Gate Bridge. They mapped out the set of neurons that, when fired together, indicated that Claude was “thinking” about the massive structure that links San Francisco to Marin County. What’s more, when similar sets of neurons fired, they evoked subjects that were Golden Gate Bridge-adjacent: Alcatraz, California governor Gavin Newsom, and the Hitchcock movie Vertigo , which was set in San Francisco. All told the team identified millions of features—a sort of Rosetta Stone to decode Claude’s neural net. Many of the features were safety-related, including “getting close to someone for some ulterior motive,” “discussion of biological warfare,” and “villainous plots to take over the world.”

The Anthropic team then took the next step, to see if they could use that information to change Claude’s behavior. They began manipulating the neural net to augment or diminish certain concepts—a kind of AI brain surgery, with the potential to make LLMs safer and augment their power in selected areas. “Let's say we have this board of features. We turn on the model, one of them lights up, and we see, ‘Oh, it's thinking about the Golden Gate Bridge,’” says Shan Carter, an Anthropic scientist on the team. “So now, we’re thinking, what if we put a little dial on all these? And what if we turn that dial?”

So far, the answer to that question seems to be that it’s very important to turn the dial the right amount. By suppressing those features, Anthropic says, the model can produce safer computer programs and reduce bias. For instance, the team found several features that represented dangerous practices, like unsafe computer code, scam emails, and instructions for making dangerous products.

The opposite occurred when the team intentionally provoked those dicey combinations of neurons to fire. Claude churned out computer programs with dangerous buffer overflow bugs, scam emails, and happily offered advice on how to make weapons of destruction. If you twist the dial too much— cranking it to 11 in the Spinal Tap sense—the language model becomes obsessed with that feature. When the research team turned up the juice on the Golden Gate feature, for example, Claude constantly changed the subject to refer to that glorious span. Asked what its physical form was, the LLM responded, “I am the Golden Gate Bridge … my physical form is the iconic bridge itself.”

When the Anthropic researchers amped up a feature related to hatred and slurs to 20 times its usual value, according to the paper, “this caused Claude to alternate between racist screed and self-hatred,” unnerving even the researchers.

Given those results, I wondered whether Anthropic, intending to help make AI safer, might not be doing the opposite, providing a toolkit that could also be used to generate AI havoc. The researchers assured me that there were other, easier ways to create those problems , if a user were so inclined.

Anthropic’s team isn’t the only one working to crack open the black box of LLMs. There’s a group at DeepMind also working on the problem, run by a researcher who used to work with Olah . A team led by David Bau of Northeastern University has worked on a system to identify and edit facts within an open source LLM. The team called the system “Rome” because with a single tweak the researchers convinced the model that the Eiffel Tower was just across from the Vatican, and a few blocks away from the Colosseum. Olah says that he’s encouraged that more people are working on the problem, using a variety of techniques. “It’s gone from being an idea that two and a half years ago we were thinking about and were quite worried about, to now being a decent-sized community that is trying to push on this idea.”

The Anthropic researchers did not want to remark on OpenAI’s disbanding its own major safety research initiative , and the remarks by team co-lead Jan Leike, who said that the group had been “sailing against the wind,” unable to get sufficient computer power. (OpenAI has since reiterated that it is committed to safety.) In contrast, Anthropic’s Dictionary team says that their considerable compute requirements were met without resistance by the company’s leaders. “It’s not cheap,” adds Olah.

Anthropic’s work is only a start. When I asked the researchers whether they were claiming to have solved the black box problem, their response was an instant and unanimous no. And there are a lot of limitations to the discoveries announced today. For instance, the techniques they use to identify features in Claude won’t necessarily help decode other large language models. Northeastern’s Bau says that he’s excited by the Anthropic team’s work; among other things their success in manipulating the model “is an excellent sign they’re finding meaningful features.”

But Bau says his enthusiasm is tempered by some of the approach’s limitations. Dictionary learning can’t identify anywhere close to all the concepts an LLM considers, he says, because in order to identify a feature you have to be looking for it. So the picture is bound to be incomplete, though Anthropic says that bigger dictionaries might mitigate this.

Still, Anthropic’s work seems to have put a crack in the black box. And that’s when the light comes in.

Human resource shortage in India’s health sector: a scoping review of the current landscape

Vini Mehta 1 ,
Puneeta Ajmera 2 ,
Sheetal Kalra 3 ,
Mohammad Miraj 4 ,
Ruchika Gallani 5 ,
Riyaz Ahamed Shaik 6 ,
Hashem Abu Serhan 7 &
Ranjit Sah 1 , 8

BMC Public Health volume 24 , Article number: 1368 ( 2024 ) Cite this article

323 Accesses

Metrics details

For healthcare delivery to be optimally effective, health systems must possess adequate levels and we must ensure a fair distribution of human resources aimed at healthcare facilities. We conducted a scoping review to map the current state of human resources for health (HRH) in India and the reasons behind its shortage.

A systematic search was conducted in various electronic databases, from the earliest available date till February 2024. We applied a uniform analytical framework to all the primary research reports and adopted the “descriptive-analytical” method from the narrative paradigm. Inductive thematic analysis was conducted to arrange the retrieved data into categories based on related themes after creating a chart of HRH problems.

A total of 9675 articles were retrieved for this review. 88 full texts were included for the final data analysis. The shortage was addressed in 30.6% studies ( n = 27) whereas 69.3% of studies ( n = 61) addressed reasons for the shortage. The thematic analysis of data regarding reasons for the shortage yielded five kinds of HRH-related problems such as inadequate HRH production, job dissatisfaction, brain drain, regulatory issues, and lack of training, monitoring, and evaluation that were causing a scarcity of HRH in India.

There has been a persistent shortage and inequitable distribution of human resources in India with the rural expert cadres experiencing the most severe shortage. The health department needs to establish a productive recruitment system if long-term solutions are to be achieved. It is important to address the slow and sporadic nature of the recruitment system and the issue of job insecurity among medical officers, which in turn affects their other employment benefits, such as salary, pension, and recognition for the years of service.

Peer Review reports

Universal healthcare is recognized as a basic human right by the World Health Organization (WHO). Human resources for health (HRH) are an essential component of effective and high-quality healthcare systems, which are responsible for the maintenance and promotion of good health. In order for health care delivery to be as effective as possible, health systems must have adequate levels and fair distribution of human resources for health [ 1 , 2 ]. HRH are defined as “the stock of all individuals engaged in the promotion, protection or improvement of population health”. This includes both public and private sectors and different domains of health systems, such as personal curative and preventive care, non-personal public health interventions, disease prevention, health promotion services, research, management, and support services (WHO, 2007) [ 1 ]. The HRH is eventually required to carry out policies, conduct processes, prescribe medication, and offer care to the populace. Therefore, it should come as no surprise that nations with low physician densities are thought to do poorly in terms of life expectancy and maternal and child mortality [ 3 , 4 ]. India is one of the 57 nations with a clear shortage of HRH [ 1 , 6 ]. WHO recommends 44.5 doctors, nurses, and midwives per 10,000 inhabitants, whereas the national density was found to be 20.6 [ 7 ]. The current health worker density is noteworthy since it represents a significant improvement from the anticipated 13.6 per 10,000 in 2005 [ 8 ]. However, the distribution of HRH throughout the states is uneven [ 9 , 10 ]. There are notable variances between urban and rural locations in HRH, with urban areas having a doctor density that is four times higher than rural ones. Availability, distribution, and quality of HRH are crucial for achieving universal health coverage (UHC) in lower-to-middle-income countries (LMICs) such as India. There have been multiple studies measuring the HRH shortage. There are also quantitative and qualitative studies looking at the reasons for the shortage. Here, we attempt to provide the most comprehensive scoping review of the estimates of the HRH shortage in India and a critical discussion of the reasons/factors underlying this shortage. To our knowledge, this would be the first review on the matter.

From a policy perspective, it is critical to comprehend how a country with a surplus of human resources structures its shortfall. Despite India’s obvious public health problems, the topic has received little attention from researchers. The academic literature on HRH in India from inception to January 2023 was reviewed here, along with the current state of affairs, trends, and the nature of the shortage. Therefore, this scoping review aims to map the current state of HRH in India and the reasons behind its shortage.

This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews (PRISMA-SCR) [ 11 ]. A scoping review was most appropriate due to the broad nature of this subject and the range of study designs included. Furthermore, it was necessary to conduct a wide search encompassing studies that examined WHO-Sustainable Development Goals (SDGs) benchmarks, Indian Public Health Standards (IPHS) guidelines, and India-SDG benchmarks. On 2-11-2022 the completed protocol was prospectively registered with the Open Science Framework ( https://doi.org/10.17605/OSF.IO/6S4QB ).

Search strategy

An exhaustive literature search was conducted to identify the shortage and reasons for shortages of HRH in India. Online electronic databases such as PubMed-Medline, Embase, Scopus, Cochrane Library, Web of Science (WoS), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and EBSCO (Global Health) were searched from the earliest available date till February 2024. Additional sources like Google Scholar, WHO library database (WHOLIS), Public Health Foundation of India Knowledge Repository (PHFI), INDMED, conference proceedings, and cross-references were explored. Non-English language publications were translated into the English language using Google Translate [ 12 ]. Contact with authors was done for any unpublished studies. A detailed search strategy is given in Table 1 for PubMed-Medline and tailored to each database when necessary [Supplementary Table 1 ].

Eligibility criteria

We sought to define and characterize the state of shortage of HRH in India. In order to be included in the review, included studies needed to focus on metrics for shortage measurements such as density estimates, raw/absolute numbers, shortfall, and vacancies. We included studies that analyzed records from national, sub-national (state), district, administrative block, and center-level based on the comprehensive comprehensive list of cadres mentioned in the National Classification of Occupations (NCO) by the Government of India (GoI) [ 13 ], and the International Standard Classification of Occupations (ISCO-08) [ 14 ] by the International Labour Office was selected. Public, private, and public-private partnerships (PPPs), and social/non-governmental/trust were taken into consideration, making the list of cadres comprehensive. In the Indian healthcare industry, health workers are broadly classified as medical health professionals, including paramedical people and non-medical workers. The latter includes numerous categories of non-medical workers. They are classified as healthcare workers. They are classified as healthcare workers since they work in healthcare facilities.

Screening and selection

We imported all search results into Zotero 5.0 and reimported all titles and abstracts into the Excel screening workbook. Two researchers independently screened (VM and RG), first by the title and abstract to verify the agreement between the reviewers on the inclusion and exclusion criteria. Case reports, letters, and narrative/historical reviews were not included in the search. The eligibility criteria were refined until a good agreement was reached. Papers without abstracts but with titles suggesting that they were related to the objectives of this review were also selected to screen the full text for eligibility. After selection, full‑text papers were read in detail by two reviewers (PA and SK). Those papers that fulfilled all of the selection criteria were processed for data extraction. Two reviewers (VM and RG) hand-searched the reference lists of all selected studies for additional relevant articles. The level of agreement between the two reviewers, calculated by Cohen’s kappa (k), was 0.92 for titles and abstracts and 0.90 for full texts. Disagreements between the two reviewers were resolved by discussion. If a disagreement persisted, the judgment of a third reviewer (MM) was considered decisive.

Also, studies examining HRH (absolute numbers/shortage/vacancy/shortfall) at national levels in urban and rural locations in India were considered for comparing the density of HRH. We carefully examined the papers to get information on HRH enumeration, openings, and deficits. For uniformity and comparison with WHO criteria, the available data was adjusted as necessary. For instance, all HRH densities are recalculated and given as 10,000 HRH workers.

Data extraction and analysis

Two authors (VM and PA) independently extracted data using specially designed data extraction forms, utilizing Microsoft Excel software. Inter-rater reliability between the two authors was 0.8 for data extraction and analysis. The following informational data fields were used: author/year of publication, location, study design, sample size, study setting, study design, data collection tool, cadre shortages, career stages, employment status, reasons for the shortage, results, and conclusion of the studies. We applied descriptive analysis for objective one and thematic analysis approach for second objective. Since articles might belong to numerous categories, the total number of articles belonging to one category may be smaller than the total number of articles belonging to all other categories. In the text and the supplemental materials, figures depict the distributions of papers by publication year, journal, and therapeutic/practice area. Inductive thematic analysis, as defined by Braun and Clarke [ 15 ], was used to arrange the retrieved data into categories based on related themes. A thorough literature review was conducted and the following steps were undertaken to create a chart of HRH-related challenges in India:

Extensive literature search: For a thorough grasp of the major themes and topics that have surfaced, a comprehensive literature review was conducted.

Developing initial codes: Data was initially coded by determining the meaningful text units related to HRH shortages in India. The key descriptive and interpretative concepts and ideas contained in the data were captured by these codes.

Identify themes: After the initial codes were identified, connections and patterns among them were explored by the reviewers. Similar codes were grouped to generate five themes that reflected the underlying meanings and concepts in the data by utilizing an iterative and inductive method. Any disagreement was resolved by discussion between the authors.

Refine themes: The five themes were refined further in terms of wording and language and finally agreed upon by all the authors ensuring that all of them are coherent and accurately reflect the underlying meanings and ideas within the data.

The available data was modified for uniformity and comparison with WHO-SDG’s benchmarks, Indian Public Health Standards (IPHS) guidelines, and India-SDG benchmarks.

Methodological quality appraisal

In line with guidelines for conducting a scoping review, no formal assessment of the methodological quality of the included articles was performed.

Search and selection results

A total of 9,580 articles were retrieved for this review, including 9483 from the databases and 97 from the additional sources. After removing duplicates, 3,155 articles remained for screening the titles. 154 articles were chosen for screening the abstracts, yielding 100 articles eligible for full-text screening. 88 full texts10,16–102 were included for the final data analysis (PRISMA flow diagram in Fig. 1 ). Study characteristics [ 10 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ] are described in detail in Supplementary Table 2 . The first research question was addressed in 30.6% of studies ( n = 27) whereas 69.3% of studies ( n = 61) addressed the second research question. In Fig. 2 , the publication years are displayed. The first article was published in 1978. 11.3% of articles ( n = 10) were published before 2010 while 85.2% were published from 2011 to 2020. Highest number of papers ( n = 10) were published in 2012 and 2017.

Flowchart summarizing the article selection process ( n – number of studies)

Articles were categorized into state level (HRH issues of only one state), national level (HRH issues of more than one state/multicentric), and international level (HRH issues of more than one country including India) for ease of understanding. 50% of studies ( n = 44) were conducted at the state level focussing on the HRH of a single state. 36.3% of studies were multicentric ( n = 32) and were conducted at the national level including more than one state of India while 13.6% ( n = 12) were international level studies conducted in more than one country including India 67.7% of studies were based on primary data while 26.8% studies were based on secondary data obtained from different sources. In 5.3% of studies both primary as well as secondary data was used to collect data.

Number of studies according to publication years

48.2% of studies were cross-sectional surveys. A questionnaire ( n = 44, 89%) was used in the majority of the surveys for data collection. Qualitative methods such as interviews were also used in surveys, albeit less frequently ( n = 16, 17.3%). One study used focus group discussion while in three studies, both interviews as well as focus group discussions were conducted. A mixed method study design (both qualitative and quantitative) was used in 6.4% of studies. In two qualitative studies, the Fujifilm Quick-Snap disposable camera was used to take photographs and conduct thematic analysis.

Studies enumerating more than one cadre were categorized as all HRH ( n = 33, 37.5%) in the present study. 35.2% ( n = 31) studies were conducted on doctors, 17% ( n = 15) on nurses, 5.6% ( n = 5) on dentists and 4.5% ( n = 4) on pharmacists (Fig. 3 ).

Distribution of studies according to HRH

Eight cross-sectional national-level studies reporting the HRH data in India are presented in this scoping review. The HRH concentrations are compiled in Fig. 3 . Comparable figures have been derived from the data since the WHO views the doctor, nurse, and midwife cadres as vital HRH. The key data sources for the studies were considered to be estimates from the Census, the National Sample Survey Organisation (NSSO), professional registration bodies, Population data and health-professional statistics, the National Health Profile, and the Indian Ministry of Statistics and Programme Implementation’s 2011 Report on Health and Family Welfare. Results depict an increase in the density of all HRH and doctors from 19.46 to 6.07 in 2012 to 29.1 and 11.3 in 2019 respectively (Fig. 4 ).

National Level HRH densities. NSSO = National Sample Survey Organization; MCI = Medical Council of India; INC = Indian Nursing Council; IMSPI = Indian Ministry of Statistics and Programme Implementation; WBO = World Bank Open Data; NHP = National Health Profile 2017; ABCE project surveys: Access, Bottlenecks, Costs, and Equity (ABCE) project surveys

Thematic analysis

The thematic analysis of data regarding the second research question yielded five kinds of HRH-related problems that are causing a scarcity of HRH in India. The outcomes of each study are described in Supplementary Tables 3 and codes identified under each theme is shown in Supplementary Table 4 [ 10 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ]. A summary of these themes is provided in Table 2 below:

A detailed description of all the themes are given below:

Theme 1: Inadequate HRH Production and recruitment

“Inadequate HRH production” emerged out to be the first theme in the present review. Eight studies reported this theme as one of the reasons for the HRH shortage in India. With nearly 1.3 billion citizens, India is the second-most populated nation in the world. This puts a tremendous amount of strain on the healthcare system, which needs a sizable number of healthcare staff to meet the population’s healthcare needs [ 80 , 88 ]. Also, India suffers from serious health disparities, with a large divide between urban and rural areas as well as across various states [ 65 , 66 , 88 ]. Healthcare professionals are in insufficient supply in many rural areas and several states, and their distribution is not equitable for instance, in urban Madhya Pradesh (MP), there are 120 doctors per 100,000 people, whereas in rural MP, there are only 12 doctors per 100,000 people [ 22 ]. With an aging population, India is going through a demographic transformation as well [ 65 , 66 , 74 , 75 , 81 ]. The demand for healthcare services will rise as a result, especially for geriatric care, which calls for a qualified staff [ 81 , 88 ]. With a large number of people coming from other nations for medical treatment, India has become a well-liked location for medical tourism. The need for healthcare personnel has expanded as a result, especially in specialized professions. However, there is a limited number of postgraduate (PG) seats in medical courses which makes it challenging to maintain supply as per the demand [ 88 ]. Moreover, there is a lack of a centralized HRH database which hinders effective planning and HRH deployment in certain locations [ 88 ].

Theme 2: Job dissatisfaction

Thirty-nine studies reported that job dissatisfaction is a major contributor to India’s shortage of Human Resources for Health (HRH). In India, a large number of healthcare professionals operate in subpar facilities with insufficient equipment. Burnout, stress, and work unhappiness may result from this [ 10 , 16 , 24 , 26 , 39 ]. Further, healthcare professionals are frequently underpaid, especially in the public sector. Many Indian healthcare employees believe that there are few opportunities for professional growth, which might cause them to feel unmotivated and dissatisfied with their jobs [ 63 , 71 , 75 ]. Therefore, in order to address the lack of HRH in India, it is imperative to address the issue of work unhappiness among healthcare professionals.

Theme 3: Brain Drain

Ten studies reported that for emerging nations like India, where the loss of trained individuals can have a large influence on economic growth and development, brain drain can be a serious issue [ 17 , 31 , 37 , 48 , 68 , 70 , 80 , 85 , 90 , 97 ]. The term “brain drain” describes the emigration of highly educated and competent people from one nation to another [ 31 , 37 ]. The desire for better employment possibilities is one of the primary causes of brain drain. Many highly qualified individuals leave their home nation in quest of better-paying work and living conditions [ 68 , 70 ]. Another factor in brain drain is a lack of employment prospects in a particular field or business. Skilled workers may search for chances abroad if they are unable to obtain employment in their field at home.

In some situations, the pursuit of educational possibilities can result in brain emigration. Professionals with advanced degrees may travel abroad to complete their studies or receive training in an area that is not offered or accessible in their native country [ 68 , 70 , 80 , 85 , 90 , 97 ].

Theme 4: Regulatory concerns

“Regulatory concerns” emerged to be another important theme. Thirty-three studies reported that to ensure an adequate supply of HRH, regulatory concerns must be resolved. A lack of qualified healthcare personnel is caused by inadequate staffing and training regulations. The health department’s protracted delivery of wage benefits and service regularisation, unequal opportunities with regard to job stability, no wage benefits, and non-acknowledgment of prior work experience, extremely complex and dispersed recruitment rules, a slow and erratic recruitment process are the key regulatory issues indicated by majority of studies [ 36 , 42 , 43 , 45 , 47 , 49 , 50 , 67 , 69 ].

Theme 5: lack of training, monitoring and evaluation

Six studies stated that in the absence of proper training healthcare professionals might not be able to pick up the skills and information required to do their professions well. This may result in a lack of qualified healthcare professionals who can deliver high-quality care. Further, without efficient monitoring and evaluation methods, it may be challenging to pinpoint the areas in which healthcare staff need more assistance or training [ 34 , 35 , 40 , 52 , 60 , 83 ]. The expertise and abilities of healthcare professionals may not match the population’s demands as a result, which could contribute to the shortage of HRH.

Theme 6: Regulatory issues

15 studies Workforce expansions are not at pace with population growth and changing dynamics of regional disease burden. Incredibly complex, non-transparent and dispersed recruitment rules, slow and extremely erratic recruitment process, health department’s protracted delivery of wage benefits and service regularisation, unequal opportunities with regard to job stability, no wage benefits, and non-acknowledgement of prior work experience are key regulatory issues. Regular vacancy planning is not done at the district level. The district health societies hire only contractual staff at the district level. Current central civil service rules, recruitment methods, appraisal systems, reward and punishment, and so on are insufficient to address human resource management issues.

This scoping review is aimed at offering a thorough comparative evaluation of research conducted on the scarcity of human resources for the health sector in India, and an analysis of the deficit distribution throughout cadres. Numerous aspects of HRH in India, as well as current and upcoming issues that must be resolved to enhance the availability of health personnel, both nationally and at the state level, have been highlighted. A total of 88 studies that reported HRH densities and reasons for HRH shortages indicated variations in their data sources like sample surveys, censuses, and registries. Thirty-three national level studies examining the HRH data in India were identified. Findings reveal that the number of doctors, nurses, and midwives in India is only one-quarter of the World Health Organization guideline of 2.3/1000 people, indicating a severe general deficit of health professionals. The workforce has an inefficient skill mix because there are at least as many doctors as nurses. Just one-third of the work force are women. Most workers reside in cities and are employed by the private sector [ 37 ].

Studies by Singh et al. and Rao et al. also report overall low numbers of qualified health workers, a high presence of unqualified health workers, particularly in rural areas, and significant differences in qualified health worker distribution between urban and rural areas [ 52 , 69 ]. A framework has been developed to identify the reasons for the underlying shortage, in the form of six themes along with proposed strategies and actions that can assist governments, policy makers and health agencies in planning, creating, and executing efficient strategies for achieving a sustainable health workforce and UHC. It is clear that there are shortages of health workers in some regions of India and in some speciality fields, but it is challenging to assess the scope and type of such shortages due to a dearth of research and health statistics. There is a glaring lack of clarity on whether a connection exists between these shortages and global migration. Although there is no specific policy agenda to control health worker migration in general, policy responses to migration of health workers are typically integrated into wider processes aimed at managing the health workforce. India’s decision-makers have divergent opinions on whether it is necessary or desirable to restrict immigration [ 78 ].

India’s health care systems and services are still developing, therefore facing issues like lack of skilled workers, absenteeism, inadequate infrastructure, and care quality [ 66 , 80 , 99 ]. One important determinant of the availability of health workforce is the density of the health personnel, relative to the population. Poorer health and service utilisation results are found in states with lower health worker densities [ 32 ]. The findings also revealed that public hospital employees were more satisfied with their recruitment and selection process, less committed to their organisation, and had lower levels of occupational stress than private hospital employees [ 41 , 49 ]. Enhancing working conditions, providing the bare necessities in terms of supplies and equipment, providing possibilities for professional growth, and strengthening supervision may prove to be equally significant in boosting employee retention in a desperate human resources situation. Furthermore, there is an unequivocal need to improve the quality of the output in terms of an explicitly stated and standardized competency framework tailored to the Indian context.

Forty-seven studies focussing on the HRH of a single state were conducted at the state level. Studies conducted in Gujarat reported that incredibly complex, non-transparent and dispersed recruitment rules, slow and extremely erratic recruitment process, the health department’s protracted delivery of wage benefits and service regularisation, unequal opportunities with regard to job stability, no wage benefits, and non-acknowledgement of prior work experience are the key factors influencing the HRH in most of the states. As opposed to extrinsic motivation, intrinsic motivation is more crucial. In order to meet the demands of service providers in terms of motivation, state health departments must address the motivation of health service providers by designing a set of strategies. State health departments, lawmakers, and reformers need to create management strategies that address both intrinsic and extrinsic motivational factors [ 77 , 89 ].

Similarly, the study conducted in Mumbai reported that the high rate of burnout syndrome among resident doctors in public sector hospitals had a negative impact on the physical and mental health of medical professionals and lowered their motivation and productivity at work [ 81 ]. Migration of Indian HRH to nations with higher incomes emerged as another significant factor that impacts HRH retention in India. A study conducted at the international level, including India, indicated that it is difficult for India to retain skilled medical personnel due to the movement of Indian HRH to nations with higher incomes, which affects government efforts to make healthcare more accessible throughout the nation [ 17 ]. Low pay and unfavourable working conditions, particularly in the private sector, are the main drivers of Indian HRH leaving India for other countries [ 21 , 75 , 78 , 85 ].

Another significant concern identified by a majority of the research is a lack of HRH databases [ 23 , 28 , 49 , 82 , 90 ]. There is a backlog of shortages because actual HR requirements are not assessed as a result of the lack of routinely updated HR planning. Although having a big workforce, the state health department lacks a specialised HR department to offer assistance with a variety of HR responsibilities. Ad hoc workers who put in long hours do not receive the same perks as regular workers. The existing sanctioning standards require an evidence-based update. Workload-based HRH deployment in different regions will guarantee sufficient availability and equitable distribution, which are required to raise the general standard of healthcare.

Inequitable distribution of HRH, lack of training, limited and poor supervision turned out to be another important factor that influence HRH in India. The most apparent doctor distributional gaps have a significant impact on health outcomes. Lack of or unequal distribution of the medical workforce may also result in inefficient utilisation of physical facilities and equipment, making the infrastructure and equipment investments useless. Zurn et al. also reported that inequitable distribution of healthcare manpower is an important challenge for health policymakers [ 103 ].

Health planners and managers must pinpoint crucial aspects, including training opportunities, which can be methodically handled at the management and policy level in order to solve this issue. Quantification, understanding, and accessibility of crucial elements can surely aid in the development of efficient administrative and human resource policies. The population is growing, and the dynamics of the regional illness burden are changing, yet workforce expansion is not keeping up. The health department’s lengthy delivery of wage benefits and service regularisation, unequal opportunities with regard to job stability, no wage benefits, and non-accountability of prior work experience are important regulatory issues. Further regulatory concerns include excessively complex, unclear, and dispersed hiring standards, a sluggish and inconsistent hiring procedure, and extremely slow and erratic recruitment rules [ 29 , 45 , 55 , 56 , 66 ]. Public-private partnerships (PPPs) are frequently employed to take advantage of the resources, skills, and knowledge of the private sector around the world [ 7 ]. In order to complement the public sector, the partnership may look into the resources and experience of the commercial sector. The findings of the present scoping review could assist decision-makers in deciding the future road map to accomplish the sustainable development goals. The study has a number of strengths. Firstly, it adds to the little body of knowledge on the shortage of HRH and the disparities in the publicly financed healthcare system in India. Secondly, the current study not only assessed the shortage of human resources for health (HRH) in India but also identified the key reasons for the shortage.

There are a few limitations as well. WHO’s methodology for determining HRH density requirement thresholds for doctors, nurses and midwives and dentists were the only considerations, thus leaving out other paramedical staff due to non-availability of data in most of the studies. The HRH system in India is divided into public and private sectors and, while the private sector lacks a formal hierarchy of structure, the public health system follows a three-tier model, with primary, secondary, and tertiary levels. In our review we witnessed a lack of literature depicting the shortages of public and private HRH. This is because we followed a scoping review approach and considered reasons for shortages published in the literature which may not be comprehensive. Another limitation is that, due to heterogeneity in the included studies, public and private sector and urban and rural comparisons couldn’t be estimated. Although we have tried to cover all the major databases, we might have missed out some of the important papers due to the non-responsiveness of authors in sharing the complete data. Furthermore, our scoping analysis did not explicitly analyse data from sources such as Rural Health Statistics, National Health Workforce Accounts, and the Periodic Labour Force Survey, which can give critical information on HRH. As a result, the assessment may not fully capture the detailed insights from these main data sources. Further research could benefit from a more direct examination of these primary data sources to gather a greater range of information about the health workforce.

The present scoping review has a few recommendations. Firstly, a comprehensive national database covering HRH cadres in public and private sectors could accurately track the state of HRH in India and make necessary policy changes to improve it. The current skill mix is dominated by doctors and consists of fewer nurses. At the national level, there needs to be a focus on both retaining nurses in the workforce and significantly boosting nursing supply. More focus will be required on the unique role of task shifting and its effects on patient care and well-being. Reduce the current human resource shortfalls in public sector organisations, especially at the primary levels, by making recruiting processes more effective through walk-in interviews or contractual/flexible norms of involvement. To strengthen the HRH in India, we require a comprehensive strategy that covers finance, infrastructure, working conditions, gender and social inequities.

This scoping review reveals that there has been a persistent shortage and inequitable distribution of human resources in India over the years, with the rural expert cadres experiencing the most shortage. The critical challenges in India’s Human Resources for Health (HRH), highlight inadequate HRH production and recruitment, job dissatisfaction, brain drain, regulatory issues, and training deficits as key factors contributing to the HRH shortage. To address these multifaceted challenges, the health department must establish a productive recruitment system to achieve long-term solutions Having clear guidelines for managing human resources and being transparent in how these are put into practice would enhance governance and foster trust among healthcare professionals, thus motivating them to work in the public sector. Therefore, the optimal management of these challenges has the power to promote retention by boosting motivation and preventing voluntary turnover.

Data availability

All data are included in the manuscript. Remaining data can be provided on reasonable request by corresponding author.

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The Possible Collapse of the U.S. Home Insurance System

A times investigation found climate change may now be a concern for every homeowner in the country..

This transcript was created using speech recognition software. While it has been reviewed by human transcribers, it may contain errors. Please review the episode audio before quoting from this transcript and email [email protected] with any questions.

From “The New York Times,” I’m Sabrina Tavernise. And this is “The Daily.”

[MUSIC PLAYING]

Today, my colleague, Christopher Flavelle, on a “Times” investigation into one of the least known and most consequential effects of climate change — insurance — and why it may now be a concern for every homeowner in the country.

It’s Wednesday, May 15.

So, Chris, you and I talked a while ago about how climate change was really wreaking havoc in the insurance market in Florida. You’ve just done an investigation that takes a look into the insurance markets more broadly and more deeply. Tell us about it.

Yeah, so I cover climate change, in particular the way climate shocks affect different parts of American life. And insurance has become a really big part of that coverage. And Florida is a great example. As hurricanes have gotten worse and more frequent, insurers are paying out more and more money to rebuild people’s homes. And that’s driving up insurance costs and ultimately driving up the cost of owning a home in Florida.

So we’re already seeing that climate impact on the housing market in Florida. My colleagues and I started to think, well, could it be that that kind of disruption is also happening in other states, not just in the obvious coastal states but maybe even through the middle of the US? So we set out to find out just how much it is happening, how much that Florida turmoil has, in fact, become really a contagion that is spreading across the country.

So how did you go about reporting this? I mean, where did you start?

All we knew at the start of this was that there was reason to think this might be a problem. If you just look at how the federal government tracks disasters around the country, there’s been a big increase almost every year in the number and severity of all kinds of disasters around the country. So we thought, OK, it’s worth trying to find out, what does that mean for insurers?

The problem is getting data on the insurance industry is actually really hard. There’s no federal regulation. There’s no government agency you can go to that holds this data. If you talk to the insurers directly, they tend to be a little reluctant to share information about what they’re going through. So we weren’t sure where to go until, finally, we realized the best people to ask are the people whose job it is to gauge the financial health of insurance companies.

Those are rating agencies. In particular, there’s one rating company called AM Best, whose whole purpose is to tell investors how healthy an insurance company is.

Whoa. So this is way down in the nuts and bolts of the US insurance industry.

Right. This is a part of the broader economy that most people would never experience. But we asked them to do something special for us. We said, hey, can you help us find the one number that would tell us reporters just how healthy or unhealthy this insurance market is state by state over time? And it turns out, there is just such a number. It’s called a combined ratio.

OK, plain English?

Plain English, it is the ratio of revenue to costs, how much money these guys take in for homeowner’s insurance and how much they pay out in costs and losses. You want your revenue to be higher than your costs. If not, you’re in trouble.

So what did you find out?

Well, we got that number for every state, going back more than a decade. And what it showed us was our suspicions were right. This market turmoil that we were seeing in Florida and California has indeed been spreading across the country. And in fact, it turns out that in 18 states, last year, the homeowner’s insurance market lost money. And that’s a big jump from 5 or 10 years ago and spells real trouble for insurance and for homeowners and for almost every part of the economy.

So the contagion was real.

Right. This is our first window showing us just how far that contagion had spread. And one of the really striking things about this data was it showed the contagion had spread to places that I wouldn’t have thought of as especially prone to climate shocks — for example, a lot of the Midwest, a lot of the Southeast. In fact, if you think of a map of the country, there was no state between Pennsylvania and the Dakotas that didn’t lose money on homeowner’s insurance last year.

So just huge parts of the middle of the US have become unprofitable for homeowner’s insurance. This market is starting to buckle under the cost of climate change.

And this is all happening really fast. When we did the Florida episode two years ago, it was a completely new phenomenon and really only in Florida. And now it’s everywhere.

Yeah. And that’s exactly what’s so striking here. The rate at which this is becoming, again, a contagion and spreading across the country is just demolishing the expectations of anyone I’ve spoken to. No one thought that this problem would affect so much of the US so quickly.

So in these states, these new places that the contagion has spread to, what exactly is happening that’s causing the insurance companies to fold up shop?

Yeah. Something really particular is happening in a lot of these states. And it’s worth noting how it’s surprised everyone. And what that is, is formally unimportant weather events, like hailstorms or windstorms, those didn’t used to be the kind of thing that would scare insurance companies. Obviously, a big problem if it destroys your home or damages your home. But for insurers, it wasn’t going to wipe them out financially.

Right. It wasn’t just a complete and utter wipeout that the company would then have to pony up a lot of money for.

Exactly. And insurers call them secondary perils, sort of a belittling term, something other than a big deal, like a hurricane.

These minor league weather events.

Right. But those are becoming so frequent and so much more intense that they can cause existential threats for insurance companies. And insurers are now fleeing states not because of hurricanes but because those former things that were small are now big. Hailstorms, wildfires in some places, previous annoyances are becoming real threats to insurers.

Chris, what’s the big picture on what insurers are actually facing? What’s happening out there numbers-wise?

This is a huge threat. In terms of the number of states where this industry is losing money, it’s more than doubled from 10 years ago to basically a third of the country. The amount they’re losing is enormous. In some states, insurers are paying out $1.25 or even $1.50 for every dollar they bring in, in revenue, which is totally unsustainable.

And the result is insurers are making changes. They are pulling back from these markets. They’re hiking premiums. And often, they’re just dropping customers. And that’s where this becomes real, not just for people who surf balance sheets and trade in the stock market. This is becoming real for homeowners around the country, who all of a sudden increasingly can’t get insurance.

So, Chris, what’s the actual implication? I mean, what happens when people in a state can’t get insurance for their homes?

Getting insurance for a home is crucial if you want to sell or buy a home. Most people can’t buy a home without a mortgage. And banks won’t issue a mortgage without home insurance. So if you’ve got a home that insurance company doesn’t want to cover, you got a real problem. You need to find insurance, or that home becomes very close to unsellable.

And as you get fewer buyers, the price goes down. So this doesn’t just hurt people who are paying for these insurance premiums. It hurts people who want to sell their homes. It even could hurt, at some point, whole local economies. If home values fall, governments take in less tax revenue. That means less money for schools and police. It also means people who get hit by disasters and have to rebuild their homes all of a sudden can’t, because their insurance isn’t available anymore. It’s hard to overstate just how big a deal this is.

And is that actually happening, Chris? I mean, are housing markets being dragged down because of this problem with the insurance markets right now?

Anecdotally, we’ve got reports that in places like Florida and Louisiana and maybe in parts of California, the difficulty of getting insurance, the crazy high cost of insurance is starting to depress demand because not everyone can afford to pay these really high costs, even if they have insurance. But what we wanted to focus on with this story was also, OK, we know where this goes eventually. But where is it beginning? What are the places that are just starting to feel these shocks from the insurance market?

And so I called around and asked insurance agents, who are the front lines of this. They’re the ones who are struggling to find insurance for homeowners. And I said, hey, is there one place that I should go if I want to understand what it looks like to homeowners when all of a sudden insurance becomes really expensive or you can’t even find it? And those insurance agents told me, if you want to see what this looks like in real life, go to a little town called Marshalltown in the middle of Iowa.

We’ll be right back.

So, Chris, you went to Marshalltown, Iowa. What did you find?

Even before I got to Marshalltown, I had some idea I was in the right spot. When I landed in Des Moines and went to rent a car, the nice woman at the desk who rented me a car, she said, what are you doing here? I said, I’m here to write a story about people in Iowa who can’t get insurance because of storms. She said, oh, yeah, I know all about that. That’s a big problem here.

Even the rental car lady.

Even the rental car lady knew something was going on. And so I got into my rental car and drove about an hour northeast of Des Moines, through some rolling hills, to this lovely little town of Marshalltown. Marshalltown is a really cute, little Midwestern town with old homes and a beautiful courthouse in the town square. And when I drove through, I couldn’t help noticing all the roofs looked new.

What does that tell you?

Turns out Marshalltown, despite being a pastoral image of Midwestern easy living, was hit by two really bad disasters in recent years — first, a devastating tornado in 2018 and then, in 2020, what’s called a derecho, a straight-line wind event that’s also just enormously damaging. And the result was lots of homes in this small town got severely damaged in a short period of time. And so when you drive down, you see all these new roofs that give you the sense that something’s going on.

So climate had come to Marshalltown?

Exactly. A place that had previously seemed maybe safe from climate change, if there is such a thing, all of a sudden was not. So I found an insurance agent in Marshalltown —

We talked to other agents but haven’t talked to many homeowners.

— named Bobby Shomo. And he invited me to his office early one morning and said, come meet some people. And so I parked on a quiet street outside of his office, across the street from the courthouse, which also had a new roof, and went into his conference room and met a procession of clients who all had versions of the same horror story.

It was more — well more of double.

A huge reduction in coverage with a huge price increase.

Some people had faced big premium hikes.

I’m just a little, small business owner. So every little bit I do feel.

They had so much trouble with their insurance company.

I was with IMT Insurance forever. And then when I moved in 2020, Bobby said they won’t insure a pool.

Some people had gotten dropped.

Where we used to see carriers canceling someone for frequency of three or four or five claims, it’s one or two now.

Some people couldn’t get the coverage they needed. But it was versions of the same tale, which is all of a sudden, having homeowner’s insurance in Marshalltown was really difficult. But I wanted to see if it was bigger than just Marshalltown. So the next day, I got back in my car and drove east to Cedar Rapids, where I met another person having a version of the same problem, a guy named Dave Langston.

Tell me about Dave.

Dave lives in a handsome, modest, little townhouse on a quiet cul-de-sac on a hill at the edge of Cedar Rapids. He’s the president of his homeowners association. There’s 17 homes on this little street. And this is just as far as you could get from a danger zone. It looks as safe as could be. But in January, they got a letter from the company that insures him and his neighbors, saying his policy was being canceled, even though it wasn’t as though they’d just been hit by some giant storm.

So then what was the reason they gave?

They didn’t give a reason. And I think people might not realize, insurers don’t have to give a reason. Insurance policies are year to year. And if your insurance company decides that you’re too much of a risk or your neighborhood is too much of a risk or your state is too much of a risk, they can just leave. They can send you a letter saying, forget it. We’re canceling your insurance. There’s almost no protection people have.

And in this case, the reason was that this insurance company was losing too much money in Iowa and didn’t want to keep on writing homeowner’s insurance in the state. That was the situation that Dave shared with tens of thousands of people across the state that were all getting similar letters.

What made Dave’s situation a little more challenging was that he couldn’t get new insurance. He tried for months through agent after agent after agent. And every company told him the same thing. We won’t cover you. Even though these homes are perfectly safe in a safe part of the state, nobody would say yes. And it took them until basically two days before their insurance policy was going to run out until they finally found new coverage that was far more expensive and far more bare-bones than what they’d had.

But at least it was something.

It was something. But the problem was it wasn’t that good. Under this new policy, if Dave’s street got hit by another big windstorm, the damage from that storm and fixing that damage would wipe out all the savings set aside by these homeowners. The deductible would be crushingly high — $120,000 — to replace those roofs if the worst happened because the insurance money just wouldn’t cover anywhere close to the cost of rebuilding.

He said to me, we didn’t do anything wrong. This is just what insurance looks like today. And today, it’s us in Cedar Rapids. Everyone, though, is going to face a situation like this eventually. And Dave is right. I talked to insurance agents around the country. And they confirmed for me that this kind of a shift towards a new type of insurance, insurance that’s more expensive and doesn’t cover as much and makes it harder to rebuild after a big disaster, it’s becoming more and more common around the country.

So, Chris, if Dave and the people you spoke to in Iowa were really evidence that your hunch was right, that the problem is spreading and rapidly, what are the possible fixes here?

The fix that people seem most hopeful about is this idea that, what if you could reduce the risk and cause there to be less damage in the first place? So what some states are doing is they’re trying to encourage homeowners to spend more money on hardening their home or adding a new roof or, if it’s a wildfire zone, cut back the vegetation, things that can reduce your risk of having really serious losses. And to help pay for that, they’re telling insurers, you’ve got to offer a discount to people who do that.

And everyone who works in this field says, in theory, that’s the right approach. The problem is, number one, hardening a home costs a fantastic amount of money. So doing this at scale is hugely expensive. Number two, it takes a long time to actually get enough homes hardened in this way that you can make a real dent for insurance companies. We’re talking about years or probably decades before that has a real effect, if it ever works.

OK. So that sounds not particularly realistic, given the urgency and the timeline we’re on here. So what else are people looking at?

Option number two is the government gets involved. And instead of most Americans buying home insurance from a private company, they start buying it from government programs that are designed to make sure that people, even in risky places, can still buy insurance. That would be just a gargantuan undertaking. The idea of the government providing homeowner’s insurance because private companies can’t or won’t would lead to one of the biggest government programs that exists, if we could even do it.

So huge change, like the federal government actually trying to write these markets by itself by providing homeowner’s insurance. But is that really feasible?

Well, in some areas, we’re actually already doing it. The government already provides flood insurance because for decades, most private insurers have not wanted to cover flood. It’s too risky. It’s too expensive. But that change, with governments taking over that role, creates a new problem of its own because the government providing flood insurance that you otherwise couldn’t get means people have been building and building in flood-prone areas because they know they can get that guaranteed flood insurance.

Interesting. So that’s a huge new downside. The government would be incentivizing people to move to places that they shouldn’t be.

That’s right. But there’s even one more problem with that approach of using the government to try to solve this problem, which is these costs keep growing. The number of billion-dollar disasters the US experiences every year keeps going up. And at some point, even if the government pays the cost through some sort of subsidized insurance, what happens when that cost is so great that we can no longer afford to pay it? That’s the really hard question that no official can answer.

So that’s pretty doomsday, Chris. Are we looking at the end of insurance?

I think it’s fair to say that we’re looking at the end of insurance as we know it, the end of insurance that means most Americans can rest assured that if they get hit by a disaster, their insurance company will provide enough money they can rebuild. That idea might be going away. And what it shows is maybe the threat of climate change isn’t quite what we thought.

Maybe instead of climate change wrecking communities in the form of a big storm or a wildfire or a flood, maybe even before those things happen, climate change can wreck communities by something as seemingly mundane and even boring as insurance. Maybe the harbinger of doom is not a giant storm but an anodyne letter from your insurance company, saying, we’re sorry to inform you we can no longer cover your home.

Maybe the future of climate change is best seen not by poring over weather data from NOAA but by poring over spreadsheets from rating firms, showing the profitability from insurance companies, and how bit by bit, that money that they’re losing around the country tells its own story. And the story is these shocks are actually already here.

Chris, as always, terrifying to talk to you.

Always a pleasure, Sabrina.

Here’s what else you should know today. On Tuesday, the United Nations has reclassified the number of women and children killed in Gaza, saying that it does not have enough identifying information to know exactly how many of the total dead are women and children. The UN now estimates that about 5,000 women and about 8,000 children have been killed, figures that are about half of what it was previously citing. The UN says the numbers dropped because it is using a more conservative estimate while waiting for information on about 10,000 other dead Gazans who have not yet been identified.

And Mike Johnson, the Speaker of the House, gave a press conference outside the court in Lower Manhattan, where Michael Cohen, the former fixer for Donald Trump, was testifying for a second day, answering questions from Trump’s lawyers. Trump is bound by a gag order. So Johnson joined other stand-ins for the former president to discredit the proceedings. Johnson, one of the most important Republicans in the country, attacked Cohen but also the trial itself, calling it a sham and political theater.

Today’s episode was produced by Nina Feldman, Shannon Lin, and Jessica Cheung. It was edited by MJ Davis Lin, with help from Michael Benoist, contains original music by Dan Powell, Marion Lozano, and Rowan Niemisto, and was engineered by Alyssa Moxley. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly.

That’s it for “The Daily.” I’m Sabrina Tavernise. See you tomorrow.

May 24, 2024 • 25:18 Whales Have an Alphabet
May 23, 2024 • 34:24 I.C.C. Prosecutor Requests Warrants for Israeli and Hamas Leaders
May 22, 2024 • 23:20 Biden’s Open War on Hidden Fees
May 21, 2024 • 24:14 The Crypto Comeback
May 20, 2024 • 31:51 Was the 401(k) a Mistake?
May 19, 2024 • 33:23 The Sunday Read: ‘Why Did This Guy Put a Song About Me on Spotify?’
May 17, 2024 • 51:10 The Campus Protesters Explain Themselves
May 16, 2024 • 30:47 The Make-or-Break Testimony of Michael Cohen
May 15, 2024 • 27:03 The Possible Collapse of the U.S. Home Insurance System
May 14, 2024 • 35:20 Voters Want Change. In Our Poll, They See It in Trump.
May 13, 2024 • 27:46 How Biden Adopted Trump’s Trade War With China
May 10, 2024 • 27:42 Stormy Daniels Takes the Stand

Hosted by Sabrina Tavernise

Featuring Christopher Flavelle

Produced by Nina Feldman , Shannon M. Lin and Jessica Cheung

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Original music by Dan Powell , Marion Lozano and Rowan Niemisto

Engineered by Alyssa Moxley

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Across the United States, more frequent extreme weather is starting to cause the home insurance market to buckle, even for those who have paid their premiums dutifully year after year.

Christopher Flavelle, a climate reporter, discusses a Times investigation into one of the most consequential effects of the changes.

On today’s episode

Christopher Flavelle , a climate change reporter for The New York Times.

A man in glasses, dressed in black, leans against the porch in his home on a bright day.

Background reading

As American insurers bleed cash from climate shocks , homeowners lose.

See how the home insurance crunch affects the market in each state .

Here are four takeaways from The Times’s investigation.

There are a lot of ways to listen to The Daily. Here’s how.

We aim to make transcripts available the next workday after an episode’s publication. You can find them at the top of the page.

Christopher Flavelle contributed reporting.

The Daily is made by Rachel Quester, Lynsea Garrison, Clare Toeniskoetter, Paige Cowett, Michael Simon Johnson, Brad Fisher, Chris Wood, Jessica Cheung, Stella Tan, Alexandra Leigh Young, Lisa Chow, Eric Krupke, Marc Georges, Luke Vander Ploeg, M.J. Davis Lin, Dan Powell, Sydney Harper, Mike Benoist, Liz O. Baylen, Asthaa Chaturvedi, Rachelle Bonja, Diana Nguyen, Marion Lozano, Corey Schreppel, Rob Szypko, Elisheba Ittoop, Mooj Zadie, Patricia Willens, Rowan Niemisto, Jody Becker, Rikki Novetsky, John Ketchum, Nina Feldman, Will Reid, Carlos Prieto, Ben Calhoun, Susan Lee, Lexie Diao, Mary Wilson, Alex Stern, Dan Farrell, Sophia Lanman, Shannon Lin, Diane Wong, Devon Taylor, Alyssa Moxley, Summer Thomad, Olivia Natt, Daniel Ramirez and Brendan Klinkenberg.

Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly. Special thanks to Sam Dolnick, Paula Szuchman, Lisa Tobin, Larissa Anderson, Julia Simon, Sofia Milan, Mahima Chablani, Elizabeth Davis-Moorer, Jeffrey Miranda, Renan Borelli, Maddy Masiello, Isabella Anderson and Nina Lassam.

Christopher Flavelle is a Times reporter who writes about how the United States is trying to adapt to the effects of climate change. More about Christopher Flavelle

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Only 5% of public healthcare facilities have adequate manpower, says MMA

Monday, 27 May 2024

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MMA launches survey to assess manpower crisis in public hospitals and clinics

Time to work together and solve parallel pathway issue, says mma, poison pen letters a sign doctors do not trust the system, says mma.

PETALING JAYA: The Malaysian Medical Association (MMA) says it is deeply concerned over the distribution of manpower in public healthcare facilities.

MMA said an ad hoc poll conducted by its section concerning house officers, medical officers and specialists (Schomos) found that only 5% of public healthcare facilities have adequate manpower, with nearly half of respondents saying that shortages are due to doctors quitting or being transferred out.

"We urge the Health Ministry to conduct a comprehensive study with transparent publication of results of the public healthcare manpower and workload to tackle the issue," said MMA president Dr Azizan Abdul Aziz in a statement on Monday (May 27).

"On the reasons for lack of manpower, nearly half (48.3%) of the 117 respondents in the ad hoc poll stated that doctors were quitting/transferring, 34 (28.8%) was because of doctors quitting and only 16 (13.6%) was due to transferring only.

"We believe one of the main reasons for this lack of manpower is brain drain, as there is a sudden increase of doctors resigning and not accepting permanent posts.

Dr Azizan said a combination of reduced number of doctors with infrastructure failure indicates that there are difficulties in providing good quality healthcare to the rakyat.

"To handle this issue effectively, MMA proposes real time data to know the extent of the shortage, better remuneration by raising civil servant salaries to be competitive with the private sector, better retention plans and repair of broken facilities, with equal money spent in both rural and urban areas.

"In the long term, we need a public services commission that can manage the healthcare system separate from the current Health Ministry-Public Services Department-Finance Ministry trinity.

"This is to allow for more flexible decision-making when it comes to staffing and service expansion needs," added Dr Azizan.

Tags / Keywords: MMA , Survey , Healthcare , Staff Shortages , Brain Drain , Doctors

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