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

2. OVERVIEW OF EMPLOYEMENT Philippine Labor Force 82 Million Population  34.2 Million in Labor Force Unemployment Rate – 13% Annually About 800,000 One out of Five Underemployed

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

4. GOVERNMENT AGENCIES THAT FACILITATE AND/OR REGULATE FILIPINO MIGRATION Civil Service Commission Commission on Filipinos Overseas Philippine Overseas Employment Agency Professional Regulation Commission Technical Education and Skills Development Authority

5. PHILIPPINE HEALTH CARE SYSTEM INFLUENCES CURRENT STATE Multifarious Issues and Problems Multiple Push Factors Devolution of Government Health Services in 1990 Private Sector Involvement Increases  1600 Hospitals/60% Private  Smaller Than Governmental Facilities Limits Access to Marginalized and Underserved Groups

6. FILIPINO NURSE MIGRATION The Philippines Major Source Country of Health Worker Migration of Nurses Destinations of Choice -- Saudi Arabia and the United States -- United Kingdom, Netherlands, Ireland

7. PROFILE OF NURSES WHO MIGRATE Predominantly Female Average Age – 32 years Leave Because  Low Salary in the Philippines  Lack of Professional Opportunities  Health Reasons  Economic Necessity

8. POSITIVE IMPACT OF HEALTH WORKER MIGRATION One Billion Dollars Contributed to Economy, Annually, via Remittance Addresses Oversupply of Health Workers Exposure to Different Culture, Work Ethics, Career Advancement

9. NEGATIVE IMPACT OF HEALTH WORKER MIGRATION Human Capital Loss Negative Impact on Families  Loss of Family Values  Social Costs Increase in Fraudulent Documents Increase in Illegal Recruiters Insufficient Numbers to Maintain Philippine Health Care System

10. POLICY IMPLICATIONS National Strategic Initiatives  Create a National Commission on Health Human Resource Development  Enactment of a National Health Service Act  Institute Reforms in Health Financing and Medical and Nursing Education

11. Nursing Education in the Philippines Commission on Graduates of Foreign Nursing Schools CGFNS Department of Global Research & Test Administration

12. Nursing Education in the Philippines History Timeline Prior to 1964 Nursing curriculum offered Medical, Surgical, Obstetrics, Pediatrics and Psychiatric Nursing specialties as separate courses Studies showed that nursing curriculum was not relevant to the health environment – Curriculum was too clinical and hospital based – 70% of citizens could not afford healthcare

13. Nursing Education in the Philippines History Timeline 1965 -1984 Health conditions of citizens deteriorated Nursing curriculum revised to provide a better fit Coursework was integrated and catered to the Philippine population Two types of programs were offered: Diploma and Degree

14. Nursing Education in the Philippines History Timeline 1989-Present Only one type of nursing program: Bachelor of Science in Nursing Nursing education programs are in institutions of higher learning After completion of courses, student must complete fieldwork

15. Nursing Education in the Philippines Current Nursing Programs Nursing education program is generally 4 years in length Curriculum includes courses in humanities, social sciences, mathematics and natural sciences Nursing content includes four major areas of nursing as well as community health, nursing research and nursing administration

16. Nursing Education in the Philippines Fieldwork 5-10 cases of assisted and actual deliveries 5-10 cases assisting in minor & major surgery 4 weeks exposure to a psychiatric hospital 12 weeks experience in community health 4 weeks experience in a communicable disease ward or hospital 4 weeks clinical experience in a tertiary hospital

17. Nursing Education in the Philippines Current Licensure Once fieldwork is completed, graduate must pass the nursing licensure examination administered by the Professional Regulation Commission (PRC) in order to practice as a registered nurse As of 2000, registered nurse license is valid until revoked or suspended

18. Top Countries of Education VisaScreen Program (2003-2004)

19. Philippine Educated Applicants (Certification Program) 1978 - 2004

20. Top Countries of Education Certification Program (1993-2004)

21. English Requirement Pass Rates 1998 – 2004

22. Average Age of CP Applicants 1978-2004

23. Gender and Marital Status CP Program, 1978-2004

24. Top Nursing Schools 1978 – 2004 Pines City Educational Center The Central Philippine University San Pedro College The United Doctors Medical Center University of Santa Tomas The University of Pangasinan

25. St. Tomas University

26. Top Five Provinces of Philippine Educated Applicants 1978 - 2004

27. Map of The Philippines Benguet Pangasinan Iloilo

28. Downtown Manila

29. Island of Palawan

30. Downtown Manila