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

Area of Science:

• Public Health
• Health Workforce Migration
• Socioeconomic Factors in Healthcare

Background:

• Healthcare worker migration from Africa impacts universal healthcare access.
• South Africa is a major exporter of health workers to high-income countries and an importer from neighboring nations.
• Despite reduced migration to the UK post-2003, South African health professionals continue to migrate globally, with limited return.

Purpose of the Study:

• To investigate the primary drivers of health worker migration from South Africa.
• To understand the post-migration experiences of South African health professionals in the UK.
• To inform policies aimed at improving health worker retention and return.

Main Methods:

• Conducted semi-structured interviews with 16 South African doctors and nurses who had migrated to the UK.
• Explored factors influencing migration decisions and subsequent experiences.

Main Results:

• Insecurity, high crime rates, and racial tensions were the predominant push factors for migration.
• Contrary to expectations, many health workers experienced de-skilling in the UK, particularly nurses.
• Working conditions and opportunities in the UK's National Health Service (NHS) were often perceived as inferior to South Africa's private sector.

Conclusions:

• Health worker migration from South Africa will likely persist until security, crime, and racial tensions are addressed.
• Improved security in South Africa could incentivize return, leveraging the attractive conditions in the private sector.
• Potential migrants need awareness of skill loss risks abroad, necessitating re-skilling initiatives to facilitate return.