The two cultures of health worker migration: a Pacific perspective.

Migration of health workers from relatively poor countries has been sustained for more than half a century. The rationale for migration has been linked to numerous factors relating to the economies and health systems of source and destination countries. The contemporary migration of health workers is also embedded in a longstanding and intensifying culture of migration, centred on the livelihoods of extended households, and a medical culture that is oriented to superior technology and advanced skills. This dual culture is particularly evident in small island states in the Pacific, but is apparent in other significant migrant source countries in the Caribbean, Sub-Saharan Africa and Asia. Family expectations of the benefits of migration indicate that regulating the migration and attrition of health workers necessitates more complex policies beyond those evident within health care systems alone.