In the pursuit of the Canadian dream: Equity and the Canadian certification of internationally educated midwives
Labor market projections indicate a shortage of health care workers across Canada and around the world. The shortage of healthcare workers is more acute in developing nations, which grapple with weak health systems unable to address high disease burdens. This situation is made worse by the movement of health personnel in search of a better standard of living, access to advanced technology and more stable political conditions in developed countries such as Canada - a process known as ‘brain drain’. Brain drain has been described as ‘a perverse subsidy’ by scholars and identified as disconcerting by the World Health Organization, which calls for the ethical recruitment of internationally educated health professionals. Significant research on the migration and recertification experiences of internationally trained physicians and nurses exists but very little has been written on internationally educated midwives (IEMs). This study uses a social equity framework and insights from Foucauldian and post-colonial feminist research to explore practices of assessment and bridging programs for IEMs; the factors that impede IEM recertification; and the ways Canadian midwifery stakeholders mitigate international migration (brain drain) and poor labor integration (brain waste) of IEMs. Data collection was primarily through key informant interviews and document analysis. The study data - gathered and analyzed in 2011/12 – is reflective of the situation of midwifery during that period. Findings from the study indicate several inequities in the recertification process of IEMs, primarily in the application process to assessment and bridging programs and in financial and geographical constraints. The study also suggests a lack of discernment by midwifery stakeholders between active and passive recruitment, and tacit support of the passive recruitment of IEMs. Questions are also raised regarding the inclusivity of the Canadian midwifery model of practice and illustrate that further research is needed.
DegreeMaster of Science (M.Sc.)
DepartmentCommunity Health and Epidemiology
ProgramCommunity and Population Health Science
CommitteeMpofu, Debbie; Janzen, Bonnie
Copyright DateNovember 2013
International Migration Labour Market Integration Internationally Educated Midwives Canadian Certification Equity