A widespread and critical shortage of midwives globally has meant that aggressive national and international recruitment strategies are sometimes adopted to try and meet the need for midwifery services. Combined with a lack of effective human resource planning, there have been reports of exploitation, unethical recruitment practices and the depletion of scarce and crucial midwifery expertise, especially in low-income countries. Recruitment practices should be guided by ethical principles such as those ensuring freedom of movement; fair and equitable working conditions; and provision of safe working environments. Midwives recruited from other countries should receive sufficient and appropriate orientation, training and education to ensure that they understand the culture and healthcare needs of the host country and the protection of women’s and midwives‘ rights.
ICM believes that the right of the individual midwife to migrate is legitimate and that midwives will continue to seek career advancement and education opportunities in countries other than their own. International recruitment provides excellent learning opportunities for midwives that will in turn enhance the care of women and their families in the midwives’ country of origin. ICM recognises however that recruitment of midwives from other countries cannot be a long-term solution to shortages in the midwifery profession; and that the international recruitment of midwives must not be carried out against the interests of another country where the lack of experienced midwives will have serious implications for the midwifery services and standards of care available to women and their newborns.
ICM is committed to supporting the ethical recruitment of midwives internationally. ICM urges midwives to contribute to the development of recruitment practices within their countries that are based on ethical principles and codes of practice to ensure that:
- The right of the individual midwife to migrate is supported.
- Low-income countries are not targeted for recruitment.
- Midwives recruited from other countries are protected from exploitation, lack of appropriate information, and false and misleading claims.
- Midwives recruited from other countries are protected by employment/industrial legislation as provided to other midwives employed on a basis of long-term residence.
- Midwives recruited from other countries have access to safe and equitable working conditions, appropriate orientation to work practices, career advancement opportunities, education, and professional development.
- Midwives recruited from other countries should be legally protected by the employing country until they start working.
- Midwives from another country must be licensed by the relevant host country Regulatory Authority.
Member Associations are urged to lobby for, and contribute to, the development and implementation of ethical guidelines and codes of conduct for the international recruitment of midwives that will provide positive opportunities for learning and professional experience to further enhance the care of women and their newborns in the context of families and communities worldwide.
Midwives, Women and Human Rights
ICM urges midwives to implement a human rights-based approach to health in all settings, and to empower women to exercise their human rights.
Legislation to Regulate Midwifery Practice
It is important to regulate and license midwives to protect the public. This regulation must be appropriate and proportional, and be in accordance with the ICM Standards for Midwifery Regulation.
Other Relevant Documents
- ICN. (2019) International Council of Nurses calls for ethical recruitment process to address critical shortage of nurses. Press Information. Available at: https://www.icn.ch/news/international-council-nurses-calls-ethical-recruitment-processaddress-critical-shortage
- International Labour Organization. (1949) C097 – Migration for Employment Convention (Revised) (No. 97). Available at: https://www.ilo.org/global/topics/fair-recruitment/
- NHS Employers. (2018) Code of Practice for International Recruitment. Available at: http://www.nhsemployers.org/your-workforce/recruit/employer-ledrecruitment/international-recruitment/uk-code-of-practice-for-international-recruitment
- Squires A. (2008) International recruitment: many faces, one goal-part 1. Nursing management, 39(9), 16–21. doi:10.1097/01.NUMA.0000335253.23789.98
- Squires A. (2008) International recruitment: Many faces, one goal-Part 2. Nursing management, 39(10), 18–26. Available at: https://doi.org/10.1097/01.NUMA.0000338303.02631.12
- Van Eyck, K. (2004) Women and International migration in the health sector, final report of Public Health Services International Participatory Action Research 2003. Public Service International, France. Available at: https://www.jstor.org/stable/4030150?seq=1
- Alinsao, V., et al. (2008) Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Nurses to the United States. HRH Global Resource Center. Available at: https://www.hrhresourcecenter.org/node/2128.html
- WHO. (2006) International migration of health personnel: a challenge for health systems in developing countries, Fifty-ninth World Health Assembly, Provisional Agenda Item 11.12. Available at: https://apps.who.int/gb/archive/pdf_files/WHA59/A59_18-en.pdf
- WHO. (2010) WHO Global Code of Practice on the International Recruitment of Health Personnel. Sixty-third World Health Assembly – WHA63.16. Available at: https://www.who.int/hrh/migration/code/code_en.pdf
Adopted at Glasgow Council meeting, 2008
Latest review at Council meeting, 2021
Due for next review 2023