International migration of the health workforce from Nepal: a review of documents on causes, solutions, and opportunities to the nation

Background: The international migration of human resources for health (HRH), who are also nation's strategic capital and a crucial component of the health system's building blocks, has an adverse effect on the health system of source country, of which Nepal is one. Objective: The study aims to contribute to the literature on the causes, responses, and prospects for Nepal in the international migration of Nepalese health professionals in relation to the strengthening of its health system.Methods: A documentary review method was employed, reviewing literature from Google Scholar, PubMed, and relevant grey sources. The data from the selected articles and grey literature were thematically summarized. The review focused on literature published between 2018 and 2024.Results: 23 out of 103 identified sources were found eligible for the review. It was found that there are several reasons why Nepalese health workers choose to work abroad, including family obligations, following trends, reluctance to work in rural areas, career opportunities, income, employment options, working conditions, education, and the nation's political and governance culture. The government ministries, including the Ministry of Health and Population, only addressed a portion of the reasons behind migration and also ran counter to the country's strategy for keeping health professionals in service in Nepal. Furthermore, the national strategy to keep Nepalese health workers in the country places less emphasis on the private healthcare sector and unemployed HRH, and more on government HRH for rural areas. The effort to make use of the expertise, contacts, and knowledge of Nepalese health workers who have emigrated was discovered to be in its early stages. Conclusions: The National HRH Strategy 2021–30 by MoHP outlines a robust framework for Nepal's health workforce, yet the out-migration of Nepal's health workforce is surging. The strategy should emphasize on addressing the root causes and potential solutions, such as: inadequate follow-up and real-need assessment of financial and non-financial incentives for health workers; education, training, and capacity-building; creation of job opportunities; effective implementation of databases and digitalization; inadequate coordination between and within sectors; etc.; and leveraging the resources available with those who have already migrated from the country.Key words: human resources for health, health system strengthening, international migration, causes, solutions, opportunities, gaps, Nepal.