Economic job factors affecting nurse emigration from South Africa : a cross-country comparative analysis of working conditions among nurses.

Abstract

For almost fifteen years, South Africa has been a target for developed countries' active recruitment of nurses and other healthcare professionals to their healthcare systems. South Africa is now a leading source of nurses for the UK, the USA, Canada, Australia, and New Zealand. This study investigates the underlying factors behind nurse emigration from South Africa by examining the differences in the economic job factors between South Africa and the UK, the US, and Australia, the three countries where the highest percentage of South African nurses are emigrating to. The economic factors investigated include wages, salary advancement for experience and length of service, hours worked, and employment-based benefits such as pension benefits, medical aid/health insurance benefits, and paid leave. Although not a focus of the empirical work, other job factors, such as poor working conditions in South African hospitals, as well as broader societal factors influencing nurse emigration, are discussed. The study was motivated by the fact that although the underlying factors that are causing South African nurses to leave for greener pastures have been identified, there exists limited empirical literature on the shortcomings of working conditions. As emigration of nurses are driven by forces present in both sending and receiving countries, a cross-country comparison of these factors leads to a greater understanding of nurse emigration from South Africa. In turn, a greater understanding can lead to effective policies improving the working conditions for South African nurses and thus improving retention. By using comparative secondary data from 2006, the findings reveal that the main difference in economic job factors lie in wages, both average wages and the possibility for salary advancement over the lifetime, and working hours. The differences in access to employment-based benefits were less significant, as benefits in South Africa tend to be high among nurses as in the comparison countries.