The present report concludes the secondphase of the cooperation between Caribbean Community(CARICOM) countries and the World Bank to build skills for acompetitive regional economy. It focuses on the nurse laborand education markets of the English-speaking (ES) CARICOM.The topic was suggested by ministers of health concernedwith chronic staffing shortages in local health facilitiesand anecdotal evidence of high migratory outflows. Thechronic staff shortages are likely to hamper the quality andefficiency of health services, both of which are criticalfactors in attracting international businesses andretirement locales. The rationale for focusing on nurses wasthat they compose the largest group of health careprofessionals in the ES CARICOM and play a critical role instrengthening health services in the face of the demographicand epidemiological transition in the region. Moreover,major achievements in improving and harmonizing curricula,degrees, and licensing procedures among the ES countries ofCARICOM facilitate the international competition for thisglobally scarce human resource. If the ES CARICOM is toaddress current and future nurse shortages, be increasinglyprotected against a large outflow of nurses, andsimultaneously recognize an individual's right tofreedom of movement and right to access health services,then various policies must be examined. Ultimately, believethat a false dichotomy exists between choosing to focus onincreasing nurse training capacity versus focusing onmanaging migration; in fact, both must be done jointly andimmediately. If the ES CARICOM is to address current andfuture nurse shortages, be increasingly protected against alarge outflow of nurses and simultaneously recognize anindividual's right to freedom of movement, the ESCARICOM must both increase the number of nurse graduates andmanage migration.
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