HOW TO MANAGE HUMAN CAPITAL OF PAKISTAN

Employee retention indicates the HR policies and practices which is used by the organization to prevent their valuable employees from leaving their jobs, and remain with organization for maximum time period. How to retain productive employees is burning problem in today competitive marketplace. Organizations are competing for the best talent employees (Porter, 2001) and to retain these talented employees. The loss of needed talent is costly because of the resulting bidding up of market salaries for experienced hires to replace them; the cost of recruiting and assimilating new talent; the lost investment in talent development; and the hidden cost of lost productivity; lost sales opportunities; and strained customer relationships (Eskildsen and Nussler, 2000).

As we know that a huge gap will be created in the retirement of baby boomer after 2014 in the USA, and other countries of the world and this will be filled from the rest of the countries including Pakistan. Now how Pakistan will retain their human capital to fulfill their internal requirement this will be a very burning issue for Pakistan in coming years because a lot number of skilled workers will be migrated but this will be necessary for the government to take steps and make policy to retain that valuable human capital.

The word “baby boomer”is used for those entire babies who are born in the New Zealand, Australia, Ireland, Iceland, Canada, USA and others countries of Europe between 1946 and 1964. In the USA general fertility rate rose what had been all time low in 1936 of 75.8 children per women of child bearing age while 122.7 a high in 1957 and then fell to 65.0 in 1976. In this period all ethnic groups, races and religions participated in the boom (Macunovich, 2000).

After the World War II baby boom generation has had a huge effect on public policy and public services. This generation will influence the society because of its increasing number and shifting needs as it ages. Decline in birth rate and increase in life expectancy, demographic shifts have changed the thinking of individual and families about their old age and retirement.

In the era between 1946 and 1964 total 77 million baby boomers were born in USA including two million of in-migrants from other part of the world who represents 37% of the USA total population (Macunovich, 2000). In 2001 the first baby boomer age was 55 years and in some pension system may be eligible to retire. In the number of retired peoples will be increased after 2014 onward. All the baby boomers will be the age of over 40 in 2005. By 2015, they will all be over 50, and the oldest baby boomers will begin to reach 70 years of age.

As we know that a huge gap will be created in the retirement of baby boomer after 2014 in the USA, and other countries of the world and this will be filled from the rest of the countries including Pakistan. Now how Pakistan will retain their human capital to fulfill their internal requirement this will be a very burning issue for Pakistan in coming years because a lot number of skilled workers will be migrated but this will be necessary for the government to take steps and make policy to retain that valuable human capital.

From 1971 to 2011, 36878 engineers, 11038 doctors, 6525 nurses, 8615 teachers and 22476 accountants has been migrated from Pakistan to different countries of the world (Bureau of Emigration & Overseas Employment, Ministry of HRD, 2011).

Human capital, however, in modern economies plays a vital and critical role. Human capital is a stockpile of competencies, knowledge and traits embodied in the workforce so as to make economic value. It is the quality gained by a workforce through education and skill. The countries which succeeded in attaining high economic growth rate laid emphasis on the education and health. Accessibility to higher education is 98% in South Korea, 94% in Finland, and 60% in Israel. Accessibility to higher education in Pakistan for the age group 17-23 is still lowest and is about 7.8%, whereas India enjoys 15% (Laghari, 2011).

Statement of Research Problem

To determine factors affecting Pakistan human capital flight and suggest measures to prevent the flight.

Research Objective

The research study aims to investigate influencing factors which affect Pakistani human capital flight to international migration particularly to baby boomer nation?

Research Methodology

(a)Type/Nature of the Research:Descriptive & Causal Research

(b)Secondary source of data will be used.

(c)Research Approach: Combination of quantitative & qualitative Research

(d)The population parameters & scope of the study will be migrated human capital of Pakistan from 1971 to 2011.

Overseas migration of healthcare personnel:

If one look around the global migration trend of personnel of different fields i.e. (health, engineering, education, management, science etc) he/she can easily conclude that most of the trained staff migrates from developing countries like Pakistan, India, and Bangladesh to developed countries like USA, UK, Canada, Australia, and New Zealand, etc. And literature also provides a lot of information on migration of such skilled and trained labor.

The developing countries have a big problem of migration of healthcare personnel to developed countries, because the developing countries already need more and more healthcare personnel. And that is the reason that the health sector of such developing countries is badly affected by such migration. According to a survey the African countries need 1 million more workers for their health sector because of lack of trained and skilled labor in health sector. Such worse situation of African countries have blamed the international migration of health workers, because of this the developing countries health workers are migrating to developed countries.The factors like lack of motivation, lack of opportunities, reward, lack of job security, poor salary affects migration of these workers.

The common solution for rich developed countries for filling the vacancies, they get the workforce from poor countries where low wage/salary system prevails.In the developing countries there is lack of uniformity between the HR policies and management system and production of health sector;as a result, the developed countries attract the workforce from developing countries by offering them good salary, remuneration system, good training and development opportunities, promotion and growth opportunities, and good working environment that leaves the poorest countries with all drain and no gain. It is suggested for each developing country that they must absorb such skilled and trained workforce; if they have no potentials to absorb then they should be careful in producing health workforce. Some countries use to get remittances while sending trained and skilled nurses abroad. In this regard Philippine is a good example, which sends their nurses abroad while receiving estimated USD 800 million annually.

Nursing Profession in Pakistan

An Overview

At the time of independence of Pakistan, 350 nurses migrated to newly formed India. Soon Pakistan was facing the problem of solving the problems of health department; therefore in 1948, Govt of Pakistan established a nursing school in Sir Gangaram Hospital Lahore. And in 1952, the first batch of trained nurses completed their nursing program. The Govt. of Pakistan then established Pakistan Nursing Council in 1973. Slowly and gradually the nursing field developed and today there are 126 schools of nursing, 141 schools of midwifery, 30 school of public health, and 9 colleges of nursing.

Local Context

The migration of health personnel from Pakistan is due to the following reasons: -

  • Income factor
  • Close relatives of migrants in foreign
  • International experience and training
  • Advance work environment and conditions abroad
  • Supportive and good supervision of management

Other factors like increasing number of health personnel, unabsorption, low wage rate, no opportunities for career development and lack of infrastructure.

Issues/challenges to Pakistan Government

The Health Department of Pakistan is facing three major challenges regarding health workforce

  1. To fill the vacancies in public health sector.
  2. Meeting the demand of minimum service delivery standards,
  3. Creating sanctioned posts for absorption of these nurses’ staff.

Bureau of Emigration and Overseas Employment

An institution in the name of Bureau of Emigration and Overseas Employment was established. It was established in October 1971, and it works under the administration of newly established Ministry of Human Resource Development. The main aim of this institution was to handle and manage the movement of health workforce across the world. The Bureau of Emigration and Overseas Employment has other attached institutions like;

  1. National Employment Bureau
  2. Protectorate of Emigrants, and
  3. Directorate of Seamen’s Welfare

Scope of Work

This bureau works in the following areas;

  1. Registering and processing of export demand of Pakistani health workforce.
  2. Facilitation of Pakistani professionals, intends to migrate for placement both in public and private sector of destination countries through the licensed Overseas Employment Promoters.

Migration Trends

If one look around the economic, political and socio-cultural conditions of Pakistan, they can easily conclude that health personnel migrate becauseretention is a big problem for trained nurses as well as doctors because in Pakistan, they seem no opportunities here.They are looking that foreign jobs will provide them quality life, and professional development.The developed countries are looking Pakistan as an attractive labor market for fulfilling the vacancies in health sector.

Before 1970 the efflux of Pakistani people was toward western countries i.e. USA, UK, and Canada. While in early 1970s the trend changed and Pakistani health workforces change their direction toward Middle East, Oil rich countries.

A negligible portion of Pakistani female is working in foreign countries. There are many factors that limit or resist the migration of female nurses. One is under 35 years of age the female nurses (health workforce) are not allowed to migrate. The religious, social, cultural factors also resist the women to migrate to west and Middle East countries. In case of India, Sri Lanka and Philippines the female migrants contribute to their national economies working abroad.

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Emigration Statistics (from 1971 to Sep 2011)

WORKERS REGISTERED FOR OVERSEAS EMPLOYMENT BY BUREAU OF EMIGRATION & OVERSEAS EMPLOYMENT DURING THE PERIOD 1971-2011 (Upto September)CATEGORY WISE

S# / Cat: / 1971-2001 / 2002 / 2003 / 2004 / 2005 / 2006 / 2007 / 2008 / 2009 / 2010 / 2011 / Total
1 / Engineer / 19565 / 861 / 821 / 880 / 951 / 1355 / 2171 / 3295 / 2352 / 2408 / 2219 / 36878
2 / Doctor / 5085 / 506 / 402 / 431 / 534 / 509 / 463 / 516 / 589 / 819 / 1184 / 11038
3 / Nurse / 4378 / 406 / 350 / 342 / 310 / 128 / 99 / 119 / 219 / 78 / 96 / 6525

STATEMENT SHOWING NUMBER OF PAKISTANIWORKERS REGISTERED FOR OVERSEAS EMPLOYMENT THROUGH BUREAU OF EMIGRATION & OVERSEAS EMPLOYMENT DURING THE PERIOD 1971-2011 (Upto September) COUNTRY WISE

S# / Countries / 1971-2000 / 2001 / 2002 / 2003 / 2004 / 2005 / 2006 / 2007 / 2008 / 2009 / 2010 / 2011 / Total
1 / U.S.A. / 802 / 788 / 310 / 140 / 130 / 238 / 202 / 297 / 232 / 184 / 196 / 133 / 3652
2 / U.K. / 1059 / 800 / 703 / 858 / 1419 / 1611 / 1741 / 1111 / 756 / 556 / 430 / 252 / 11296
3 / South Africa / 24 / 3 / 8 / 59 / 7 / 38 / 65 / 45 / 93 / 314 / 184 / 107 / 947
4 / Japan / 91 / 24 / 10 / 12 / 12 / 22 / 53 / 33 / 45 / 48 / 30 / 36 / 416
5 / China / 137 / 4 / 8 / 1 / 3 / 154 / 435 / 300 / 172 / 312 / 191 / 137 / 1854
6 / Sweden / 46 / 2 / 0 / 0 / 8 / 15 / 3 / 3 / 8 / 21 / 28 / 59 / 193

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WHO GLOBAL CODE OF PRACTICE

An Overview

In World Health Assembly a resolution was passed after requesting to the Director General that a voluntary code of practice on recruitment of international health personnel may please be developed in order to maintain a standard policy for recruitment of international health personnel. The Kampala Declaration adopted at the first human resource management for health in March 2008, which further encouraged the WHO to step and develop the code of practice. In 63 World Health Assembly a revised draft of global code of practice was presented in World Health Organization. The main aim of the WHO Global Code of Practice is expected to be a core component of bilateral, national, regional and global strategies for handling and solving issues related to health personnel recruitment, and strengthening of healthcare system.

Objectives of Who Global Code of Practice

The main objectives of the Who Global Code of Practiceare listed next:

  1. To establish voluntary principles on ethical international recruitment of health personnel.
  2. To serve for member states in establishing legal and institutional framework required for international recruitment of health personnel.
  3. To provide guidance that is useful for formulation and implementation of bilateral agreements.
  4. To facilitate international discussion on matters related to ethical international recruitment and health personnel.

Healthcare in Pakistan

An Overview/ Historical Perspective

If we look the history of Pakistan we would be able to conclude that there were only two medical colleges in Pakistan at the time of independence in 1947. But in 2011 after 60-65 years there 70 medical and dental colleges, 109 nursing schools, 7 nursing colleges, 26 public health schools, 141 midwifery schools.According to PMDC report 2011, there are now 32 medical schools in public sector and 39 in private sectorcontributing to the GDP, while in 1947 there were only 87 medical doctors, but according to PMDC record there are 136648 doctors and 25807 specialists across the country. According to estimation there were 25000 doctors working overseas.

Talking about nursing sector of Pakistan, in 1947 there were only 400 nurses in Pakistan while in 2011 there were 54987 qualified nurses. In 1947 there were only 292 hospitals with 14000 beds facilities while today there 920 public sector hospitals, 800 private sector hospitals offering facilities of 100000 beds.

Evolving Structure of Health and Present Scenario

Aptly speaking, health sector of Pakistan has many challenges as; increasing of poverty, and burden of diseases, consequently the situation is going to be worse because of increase in aged and young age group population.After becoming Pakistan, all sectors education, science, sports, and health were in a very critical situation, but slowly and gradually time changed and departments came to work properly. By the late 1980s there were basic health units in each union council which covers 15000 to 20000 of population. From 1980s till date there are 550 regional health centers, 4870 basic health units, 4916 dispensaries compare to 700 in 1947.

Keeping in view the above evolution and present scenario of health sector of Pakistan, an enough and sufficient number of trained and skilled nurses, doctors, technicians, surgeons, and specialists are required.

Medical Education Institutions-Country Profile

Training Inst: / No / Category / Annual Approx Output
Medical Colleges / 74 / Doctors / 9000
Dental Colleges / 32 / Dentists / 2000
Institution for Pharmacy / 28 / B. Pharmacy / 2,000

Universities/Institutions in Pakistan offering Degrees in the field of Medicine/Dentistry

Name of the Universities
  1. University of the Punjab, Lahore

  1. Bahria University, Shangrilla Road, Islamabad.

  1. University of Health Sciences, Lahore.

  1. Quaid-e-Azam University, Islamabd.

  1. Gandhara University, University Town, Peshawar.

  1. Ziauddin Medical University, Clifton, Karachi.

  1. Dow University of Health Sciences, Baba-e-Urdu Road, Karachi.

  1. Liaquat University of Medical & Health Sciences,Jamshoro

  1. University of Sindh, Jamshoro

  1. Isra University, Hyderabad

  1. The Aga Khan University, Karachi.

  1. Baqai Medical University, Karachi.

  1. University of Karachi, Karachi.

  1. Hamdard University, Karachi.

  1. Khyber Medical University, Peshawar

  1. Hazara University, Mansehra

  1. University of Balochistan, Quetta.

  1. Foundation University, Islamabad.

  1. Riphah International University, Rawalpindi.

  1. University of Peshawar Peshawar

  1. National University of Science & Technology, Rawalpindi.

  1. King Edward Medical University, Lahore.

Other Institutions
The College of Physicians and Surgeons Pakistan
Pakistan Institute of Engineering Applied Sciences

Medical Colleges-Provincial Breakup

Province / Public Medical Colleges / Private Medical Colleges
Federal / 0 / 3
Punjab / 12 / 20
Sindh / 8 / 12
Khyber Pakhtunkhwa / 8 / 8
Baluchistan / 1 / 0
AJ&K / 0 / 1
Total / 30 / 44
Grand Total / 74

Recognized Medical Colleges in Pakistan

Public Medical Colleges in Punjab
  1. AllamaIqbal Medical College, Lahore

  1. Army Medical College, Rawalpindi.

  1. Fatima Jinnah Medical College for Women, Lahore.

  1. King Edward Medical College, Lahore

  1. Nishtar Medical College, Multan Recognized.

  1. Punjab Medical College, Faisalabad.

  1. Quaid-e-Azam Medical College, Bahawalpur.

  1. Rawalpindi Medical College, Rawalpindi.

  1. Services Institute of Medical Sciences, Lahore.

  1. Sargodha Medical College, Sargodha.

  1. ShaikhZayed Medical College, Rahim Yar Khan.

  1. Nawaz Shairf Medical College, Gujrat.

  1. Sheikh Khalifa Bin Zayed Al-Nahyan Medical College Medical College, Lahore.

Private Medical Colleges in Punjab
  1. FMH College of Medicine & Dentistry, Lahore

  1. Foundation University Medical College, Rawalpindi

  1. Islamic International Medical College, Rawalpindi

  1. Lahore Medical & Dental College, Lahore.

  1. Wah Medical College, Wah Cantt

  1. University Medical College, Faisalabad

  1. University College of Medicine & Dentistry, Lahore

  1. CMH Lahore Medical College, Lahore

  1. Independent Medical College, Faisalabad

  1. Sharif Medical & Dental College, Lahore

  1. Continental Medical College, Lahore

  1. AkhtarSaeed Medical & Dental College, Lahore

  1. Central Parks Medical College, Lahore

  1. Multan Medical & Dental College,Multan

  1. Shalamar Medical & Dental College, Lahore

  1. Avicenna Medical College, Lahore

  1. Rashid LatifMediacl College,Lahore

  1. Islam Mediacl College,Sialkot

  1. AmnaInayat Medical College,Sheikhupura

Public Medical Colleges in Sindh
  1. Chandka Medical College, Larkana.

  1. Dow University of Health Sciences, Karachi

  1. Sindh Medical College, Karachi

  1. Karachi Medical & Dental College, Karachi

  1. Liaquat University of Medical & Health Sciences, Jamshoro.

  1. Nawabshah Medical College for Girls, Nawabshah

  1. Dow International Medical College, Karachi

  1. Ghulam Mohammad Maher Medical College, Sukkur

Private Medical Colleges in Sindh
  1. Aga Khan University Medical College, Karachi

  1. Baqai Medical College, Karachi

  1. Faculty of Medicine & Allied Medical Sciences Isra University, Hyderabad. .

  1. Hamdard College of Medicine & Dentistry Karachi.

  1. Jinnah Medical & Dental College, Karachi

  1. Sir Syed College of Medical Sciences for Girls, Karachi.

  1. Ziauddin Medical College, Karachi

  1. Muhammad Medical College, Mirpurkhas

  1. Liaquat College of Medicine & Dentistry, Karachi

  1. Liaquat National Medical College, Karachi.

  1. Bahria University Medical & Dental College, Karachi.

  1. Al-Tibri Medical College, Karachi.

Province of Baluchistan
1. Bolan Medical College, Quetta
Province of Khyber Pakhtunkhwa
Public Medical Colleges
  1. Ayub Medical College, Abbottabad

  1. Khyber Medical College, Peshawar

  1. Gomal Medical College, Dera Ismail Khan

  1. Saidu Medical College, Swat.

  1. KUST Institute of Medical Sciences, Kohat

  1. Khyber Girls Medical College, Peshawar

  1. Badsha Khan Medical College, Peshawar

Private Medical Colleges
  1. Frontier Medical College, Abbottabad

  1. Kabir Medical College/GIMS, Peshawar

  1. Women Medical College, Abbottabad

  1. Peshawar Medical College, Peshawar

  1. Abbottabad International Medical College, Abbottabad

  1. Jinnah Medical College, Peshawar

  1. RehmanMediacl College, Peshawar

  1. Pak International Medical College, Peshawar

Retention Strategies: