Does the NGO sector undermine national health providers? How to measure migrations of health workers between public and NGO care providers on a cross-country basis

This thesis reviews the question of whether the health services provided by Non-Governmental Organizations (NGOs) lead to internal brain drains of health workers out of public health systems, within individual countries. Studies that measure internal brain drains are reviewed in migration and public / global health literatures. Methods for measuring internal brain drains of health workers from public providers are considered, along with models to establish causal links between the recruitment of skilled workers by NGOs, and public sector employment levels. Existing secondary datasets are analyzed to reveal the absence of indicators that measure this study's key variables. The lack of proxies for variables of interest makes it impossible to determine whether internal brain drain processes are occurring on a cross-country basis, without collecting primary data. Looking beyond present constraints, this thesis considers alternative ways to measure internal brain drains, as well as directions for future research. Keywords: global health, health systems strengthening, health workers, human resources for health, internal brain drain, non-governmental organization