Motivations and aspirations of Nepalese nurses towards international migration: a mixed-method systematic review

Background: Nepalese nurses have increasingly sought employment abroad, primarily in high-income countries where the demand for skilled healthcare professionals is high. It is estimated that more than one third of nurses registered with the Nepal Nursing Council have initiated the process to practice abroad.Aim: This systematic review examines the motivations and aspirations of Nepalese nurses towards international migration, highlighting the socio-economic, professional, and personal determinants that influence their decisions.Methods: A comprehensive search was conducted on PsyInfo, CINAHL, MEDLINE, and Web of Science focusing on studies published in English before March 2025 that explored Nepalese nurses' migration intention and associated push and pull factors. Exploratory meta-analysis was conducted on quantitative outcomes like migration intention, starting migration planning, timeline for future migration, destination country, plan to return, push and pull factors for migration, and impact of nurse migration. Qualitative findings were analyzed using thematic synthesis. A mixed-methods synthesis approach was used to integrate findings from both the quantitative and qualitative studies.Results: Meta-analysis showed that 87% of nursing students and qualified nurses intended to migrate internationally. Australia (46%) was the most preferred destination, followed by the United States (38%), the UK (27%), and Canada (23%). Key motivations included higher income, advanced education and training opportunities, better working conditions, and career advancement. Personal goals, such as achieving financial stability for families and improved quality of life, and desire for personal freedom influenced the decision. Push factors in Nepal included low pay, limited professional growth, and poor workplace environments.Conclusion: To retain nurses, Nepal should prioritize fair compensation, professional development, and job security. Destination countries should uphold ethical recruitment, strengthen health systems in resource-limited areas, and support nursing education and retention.