Labour precariousness in the Mexican health workforce: taking to the surface a neglected problematic issue

Area of Science:

• Health Policy
• Occupational Health
• Health Workforce Research

Background:

• Job precariousness among health workers in low- and middle-income countries is under-quantified.
• Analytical models for human resources in health often overlook work precarity.
• Addressing job precariousness is crucial for enhancing health system performance.

Purpose of the Study:

• To quantify job precariousness trends among physicians and nurses in Mexico from 2005 to 2022.
• To analyze differences in precarious employment between the public and private sectors.
• To examine the evolution of the private-public gap in precariousness.

Main Methods:

• Analysis of pooled cross-sectional data from Mexico's National Occupation and Employment Survey (2005-2022).
• Inclusion of 31,394 physicians and nurses, representing approximately 7.8 million workers.
• Use of pooled state and year fixed-effects multiple logistic regression to estimate precarious employment likelihood.

Main Results:

• Sustained growth in labor precariousness: physicians from 58.7% to 75.5%, nurses from 49.0% to 67.3%.
• Labor precariousness was consistently higher in the private sector for both professions.
• The private-public precariousness gap narrowed more significantly and rapidly among physicians than nurses, with greater convergence in poorer regions.

Conclusions:

• Differences in labor market composition, particularly the historical link of physicians to the private sector, contributed to increased precariousness.
• The narrowing of the public-private gap is attributed to the recent expansion of precarious work in the private sector.
• Development of regulatory policies is essential to mitigate precariousness and its health system impacts across both sectors.