Margaret Walton-Roberts

India has become one of the key sources for the global nursing labour force. While there is significant research on the experiences of Indian‐trained nurses in destination countries and their motivations to migrate, relatively less work explores the role of the sending state in this policy field, and rarely are subregional differences considered. In this paper, we focus on the policies and processes that are designed to or otherwise affect nurse migration from India. We draw upon three sources of data: (1) a scoping review of published literature on health worker migration in India, (2) a survey of 1736 health workers in India and (3) interviews with 60 key political and organisational representatives across two regions of India—Kerala and Punjab—as well as from the Delhi Capital Region. Our assessment of the role of the Indian sending state in the international migration of nurses reveals the existence of contradictory policies that are regionally differentiated and distinct. These important subnational jurisdictional policies differ in terms of context, competencies and coherence in managing health worker migration and its resulting impacts on health systems. This research highlights the need to understand jurisdictional differences in any analysis of sending state perspectives on international health worker migration to more fully assess its implication for domestic health systems and changing dynamics in international migration.

This chapter examines the evolving dynamics of international student mobility (ISM) in the context of medical education, with a particular focus on Indian students pursuing undergraduate medical degrees in non-Anglophone countries such as Russia, Ukraine and China. It highlights the shift from traditional South-North migration patterns to a more diversified landscape, where Asian countries are becoming significant destinations for medical education. The chapter explores the factors influencing Indian students’ decision to study abroad, including the affordability of education and the perception of higher quality in foreign institutions. It also addresses the challenges faced by these students, such as the need to pass the foreign medical graduate examination (FMGE) to practice in India and the impact of geopolitical events like the war in Ukraine and the COVID-19 pandemic on their education and career trajectories. The study draws on various data sources, including government records and media narratives, to provide a comprehensive overview of the current trends and implications of ISM in medical education within the Global South, offering insights into the policy ramifications for both sending and receiving countries.

With international migration on the rise and the critical need for labour in the global north, governments are increasingly focused on the employment integration of immigrants. Studies demonstrate that where immigrants choose to settle has an impact on how effectively they integrate into employment. In Canada, there has been a shift in immigrant settlement patterns away from large urban centres toward small and mid‐sized cities. Understanding how local context shapes the employment integration of newcomers in their first few years of arrival is critical in informing policy to improve employment outcomes. Using a case study approach, this study explores the employment experiences of recent immigrants in a mid‐sized city in Ontario, Canada to identify challenges and opportunities they face integrating into the local labour market. Findings were framed into an emerging model of immigrant employment‐seeking strategies that identified how individual and contextual factors affect immigrant labour market integration. At the individual level, despite employing several strategies, most immigrants found themselves in low‐skilled positions. At the city level, challenges were associated with a concentration of specific industries with a lower demand for diverse skill sets. Providing support at critical points of the integration process including prearrival and during the initial years postmigration can accelerate the uptake of immigrants into commensurate employment. This study contributes to further understanding of the important role of cities in ensuring the efficient and effective employment integration of immigrants into the Canadian labour market.

Many scholars have used neoliberalism as an analytical framework to examine the Philippines' labour export policy. While neoliberalism entails a retreat of the state in favour of market reforms, evidence shows that state intervention of the market becomes larger and stronger over time. This paper utilises liberal neo‐statism as an alternative framework to understand the Philippines' nurse labour export by explaining that the state's role is larger than and goes beyond labour brokerage. Following the historical institutionalism approach, we show the significant timing, sequence, and path dependence that affect the emergence of institutions that govern the Philippines' nurse labour export. Our paper reveals how specific policies and regulations in labour export are tucked within the disguise of market reforms, but which are manifest within a larger state's control. These policies serve as the state's apparatus for remittance generation and protection of migrant labour rights and welfare.

Aims: This article describes the sociodemographic characteristics of internationally educated nurses since the change in the registration examination in 2015. It aims to investigate the association between internationally educated nurses' sociodemographic characteristics and their successful integration into the nursing workforce in Canada.Design: Cross‐sectional and secondary data survey questions.Methods: This study adopts a cross‐sectional and secondary data analysis, utilising data from IENs who engaged with internationally educated nurse initiatives such as the Creating Access to Regulated Employment Centre for Internationally Educated Nurses (CARE) or initiated the registration process with the College of Nurses of Ontario (CNO) in 2015 and after.Results: There were 259 participants, with 155 participants from primary data collection and 104 participants from secondary data sources. Quantitative analysis reveals that most participants are females, under 40 years old, educated in English and hold at least a bachelor's degree in nursing, with 47.3% of internationally educated nurses migrated from India and the Philippines. Significant associations were identified between internationally educated nurses having CARE membership and the currency of nursing practice and their successful outcomes.Conclusion: Recognising and addressing the unique needs of IENs is essential for their successful integration into the Canadian healthcare workforce, thereby ensuring resilience and cultural competence in nursing for the future.Implications for the Profession: This analysis highlights the impact of sociodemographic characteristics of internationally educated nurses on their successful outcomes and underscores the diversity and richness they bring to the healthcare landscape. Since internationally educated nurses continue to experience challenges while integrating into the Canadian nursing workforce, these findings have substantial implications for nursing policy, practice, professional development and research.

Background: Canada is less successful in integrating internationally educated nurses (IENs) into the nursing workforce than other developed countries like Australia. Objective & Design: This scoping review compares the integration trends of internationally educated nurses in Canada with those in Australia. Data Sources & Methods: Nine online databases were searched for English-language studies on the integration pathways of IENs in Canada or Australia. Results: Twenty-seven articles included in the review were completed in Canada (62.96%, n=17) and Australia (37%, n=10). The articles reported on internationally educated nurse integration in the workforce (18.5%, n=5) and workplace (66.7%, n=18), and four studies (14.8%) examined both workforce and workplace integration. This review highlighted the difficulties IENs encounter during their integration in Canada and Australia. Collaboration among stakeholders in Australia resulted in better integration of IENs. Conclusion: This review suggests Canadian ministries collaborate and align their policies to support better integration of internationally educated nurses into the Canadian health system.

Diasporas are increasingly seen as an economic resource and new agents in sending state development regimes. The nature of these state‐diaspora relationships are matters of increasing interest to scholars. In this paper we examine the case of India and the current government's engagement with diaspora groups, especially alumni networks of Indian Institutes of Technology and Management. Alumni networks provide conduits for diasporas to inform homeland affairs and for home nations to project their brand of soft power and technological modernity, suggesting novel and emerging forms of transnational governance particularly in education and technological development. We offer a critical conceptual review of these issues by tracing prominent Indian diaspora alumni actors and emerging transnational diasporic governance networks and how these might inflect “national” policy frameworks in sending countries through the reproduction of caste and class privilege.

This chapter charts a decade of relations between India and the United Arab Emirates (UAE) through the prism of the migration of nurses and related health sector investments, especially in the nursing education in India. It reviews the relevance of recent bilateral agreements to the education and migration of nurses, the type of negotiations that have occurred in terms of managing the education, movement, and regulation of these migrant workers. It details the various Memoranda of Understanding (MOUs) and agreements signed between the two countries regarding health sector investment and labour migration and considers how they may relate to the education, movement, and regulation of nurses, including responses to the global COVID-19 pandemic. Over the past decade, deepening relations between India and the UAE are evident in terms of health sector investment and migrant labour in general, but there is a paradoxical lack of bilateral agreement specifically regarding the mobility of nurses. We suggest that there is a need for specific/targeted negotiation regarding state obligations and rights about the nursing education, deployment, and utilisation of India’s migrant nurses in UAE. The chapter further considers the current context for Indian nurses working in the UAE in terms of their rights, protections, and mobility, and how the global COVID-19 pandemic has informed this relationship and impacted the nurse migration process.

The increasing complexity of the migration pathways of health and care workers is a critical consideration in the reporting requirements of international agreements designed to address their impacts. There are inherent challenges across these different agreements including reporting functions that are misaligned across different data collection tools, variable capacity of country respondents, and a lack of transparency or accountability in the reporting process. Moreover, reporting processes often neglect to recognize the broader intersectional gendered and racialized political economy of health and care worker migration. We argue for a more coordinated approach to the various international reporting requirements and processes that involve building capacity within countries to report on their domestic situation in response to these codes and conventions, and internationally to make such reporting result in more than simply the sum of their responses, but to reflect cross-national and transnational interactions and relationships. These strategies would better enable policy interventions along migration pathways that would more accurately recognize the growing complexity of health worker migration leading to more effective responses to mitigate its negative effects for migrants, source, destination, and transit countries. While recognizing the multiple layers of complexity, we nevertheless reaffirm the fact that countries still have an ethical responsibility to undertake health workforce planning in their countries that does not overly rely on the recruitment of migrant health and care workers.