The University of Southampton
University of Southampton Institutional Repository

Security and skills: the two key issues in health worker migration

Security and skills: the two key issues in health worker migration
Security and skills: the two key issues in health worker migration
Background: Migration of health workers from Africa continues to undermine the universal provision of quality health care. South Africa is an epicentre for migration – it exports more health workers to high-income countries than any other African country and imports health workers from its lower-income neighbours to fill the gap. Although an inter-governmental agreement in 2003 reduced the very high numbers migrating from South Africa to the United Kingdom, migration continues to other high-income English-speaking countries and few workers seem to return although the financial incentive to work abroad has lessened. A deeper understanding of reasons for migration from South Africa and post-migration experiences is therefore needed to underpin policy which is developed in order to improve retention within source countries and encourage return.

Methods: Semi-structured interviews were conducted with 16 South African doctors and nurses who had migrated to the United Kingdom. Interviews explored factors influencing the decision to migrate and post-migration experiences.

Results: Salary, career progression, and poor working conditions were not major push factors for migration. Many health workers reported that they had previously overcome these issues within the South African healthcare system by migrating to the private sector. Overwhelmingly, the major push factors were insecurity, high levels of crime, and racial tension. Although the wish to work and train in what was perceived to be a first-class care system was a pull factor to migrate to the United Kingdom, many were disappointed by the experience. Instead of obtaining new skills, many (particularly nurses) felt they had become ‘de-skilled’. Many also felt that working conditions and opportunities for them in the UK National Health Service (NHS) compared unfavourably with the private sector in South Africa.

Conclusions: Migration from South Africa seems unlikely to diminish until the major concerns over security, crime, and racial tensions are resolved. However, good working conditions in the private sector in South Africa provide an occupational incentive to return if security did improve. Potential migrants should be made more aware of the risks of losing skills while working abroad that might prejudice return. In addition, re-skilling initiatives should be encouraged.
1654-9716
Bidwell, Posy
befaab7f-81ad-4e10-9925-5dc7d7ac099f
Laxmikanth, Pallavi
f83f0015-1b53-4e2b-ad41-80d896d94070
Blacklock, Claire
c2d550f3-22dd-4936-8692-82d8b21b8301
Hayward, Gail
91362d6f-3c3b-4eae-8fc8-1571ccf184c1
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Peersman, Wim
ee1ed85b-8434-4e17-a2fc-92602abcb0fc
Moosa, Shabir
96f8c99d-602a-4122-8c2e-ed2a55114ea7
Mant, David
d2e30212-70ec-48c9-b80a-a45cf4bcc46e
Bidwell, Posy
befaab7f-81ad-4e10-9925-5dc7d7ac099f
Laxmikanth, Pallavi
f83f0015-1b53-4e2b-ad41-80d896d94070
Blacklock, Claire
c2d550f3-22dd-4936-8692-82d8b21b8301
Hayward, Gail
91362d6f-3c3b-4eae-8fc8-1571ccf184c1
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Peersman, Wim
ee1ed85b-8434-4e17-a2fc-92602abcb0fc
Moosa, Shabir
96f8c99d-602a-4122-8c2e-ed2a55114ea7
Mant, David
d2e30212-70ec-48c9-b80a-a45cf4bcc46e

Bidwell, Posy, Laxmikanth, Pallavi, Blacklock, Claire, Hayward, Gail, Willcox, Merlin, Peersman, Wim, Moosa, Shabir and Mant, David (2014) Security and skills: the two key issues in health worker migration. Global Health Action, 7. (doi:10.3402/gha.v7.24194).

Record type: Article

Abstract

Background: Migration of health workers from Africa continues to undermine the universal provision of quality health care. South Africa is an epicentre for migration – it exports more health workers to high-income countries than any other African country and imports health workers from its lower-income neighbours to fill the gap. Although an inter-governmental agreement in 2003 reduced the very high numbers migrating from South Africa to the United Kingdom, migration continues to other high-income English-speaking countries and few workers seem to return although the financial incentive to work abroad has lessened. A deeper understanding of reasons for migration from South Africa and post-migration experiences is therefore needed to underpin policy which is developed in order to improve retention within source countries and encourage return.

Methods: Semi-structured interviews were conducted with 16 South African doctors and nurses who had migrated to the United Kingdom. Interviews explored factors influencing the decision to migrate and post-migration experiences.

Results: Salary, career progression, and poor working conditions were not major push factors for migration. Many health workers reported that they had previously overcome these issues within the South African healthcare system by migrating to the private sector. Overwhelmingly, the major push factors were insecurity, high levels of crime, and racial tension. Although the wish to work and train in what was perceived to be a first-class care system was a pull factor to migrate to the United Kingdom, many were disappointed by the experience. Instead of obtaining new skills, many (particularly nurses) felt they had become ‘de-skilled’. Many also felt that working conditions and opportunities for them in the UK National Health Service (NHS) compared unfavourably with the private sector in South Africa.

Conclusions: Migration from South Africa seems unlikely to diminish until the major concerns over security, crime, and racial tensions are resolved. However, good working conditions in the private sector in South Africa provide an occupational incentive to return if security did improve. Potential migrants should be made more aware of the risks of losing skills while working abroad that might prejudice return. In addition, re-skilling initiatives should be encouraged.

Full text not available from this repository.

More information

Accepted/In Press date: 26 June 2014
Published date: 28 July 2014
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 403731
URI: https://eprints.soton.ac.uk/id/eprint/403731
ISSN: 1654-9716
PURE UUID: dfaedaa3-7d38-4baa-b103-0c7a2b6285d6
ORCID for Merlin Willcox: ORCID iD orcid.org/0000-0002-5227-3444

Catalogue record

Date deposited: 09 Dec 2016 12:02
Last modified: 17 Sep 2019 00:27

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×