Migration Intentions of Nursing Students in Ghana: Implications for Human Resource Development in the Health Sector

Exploring the factors affecting undergraduate nursing students' migration intention: A qualitative study

BACKGROUND

The escalating global nursing shortage, fueled by the migration of healthcare professionals from resource-constrained nations to those with greater economic prosperity, presents a formidable challenge to healthcare systems worldwide. Nepal, grappling with a significant brain drain of its nursing workforce, serves as a poignant illustration of this phenomenon. The departure of skilled nurses not only jeopardizes the country's healthcare quality but also underscores the urgent need to address the underlying educational and systemic deficiencies contributing to this trend.

AIM

The study aims to explore the early formation of migration intentions among undergraduate nursing students in Nepal and identify key factors influencing their decision to pursue opportunities abroad.

DESIGN

A descriptive qualitative research design.

SETTINGS

The study was conducted at two urban nursing colleges in Nepal.

PARTICIPANTS

Seventeen nursing students in their final year of undergraduate studies.

METHODS

Data were collected via semi-structured interviews and analyzed using thematic analysis.

RESULTS

The thematic analysis unearthed four principal themes: (1) Aspirations Beyond Borders: Structural and Systemic Catalysts; (2) Navigating Personal Ambitions; (3) Socio-Political Currents Influencing Career Pathways; (4) Economic Incentives and Realities: Weighing the Prospects.

CONCLUSION

The study's findings highlight the need for systemic changes to retain nursing professionals in Nepal. There is a significant gap between policy initiatives aimed at improving the status of nursing and the persistent challenges nursing students face. This gap fosters disillusionment and drives migration intentions. The research underscores the urgent need to address systemic deficiencies, empower nurses, and ensure equitable recognition. These actions are crucial to cultivating a sustainable nursing workforce dedicated to advancing health equity.

Toxic leadership behaviour of nurse managers and turnover intentions: the mediating role of job satisfaction

INTRODUCTION

Globally, hospitals are confronted with major challenges of turnover of nurses. Knowledge of the factors that account for the turnover of nurses will aid in creating strategies that will enhance nurse managers' leadership behaviour and job satisfaction to reduce turnover. The study, therefore, investigated the mediating role of job satisfaction on toxic leadership and turnover intentions of nurses.

METHODS

A multi-centre cross-sectional study was undertaken to assess 943 nurses using the Toxic-leadership Behaviour of Nurse Managers scale, Minnesota Satisfaction Questionnaire and Turnover Intention scale. Descriptive statistics was used to assess the prevalence of toxic leadership, job satisfaction and turnover and Pearson's correlation examined the relationships between the variables. Hayes' PROCESS macro approach of mediation was used to determine the effect of toxic leadership behaviour on the turnover intention on the possible influence of job satisfaction.

RESULTS

The response rate for the study was 76.0%. Mean scores for turnover intentions and toxic leadership behaviour were 3.71 and 2.42 respectively. Nurses who work with toxic managers showed a higher propensity to leave their jobs. Job satisfaction acted as a mediator between the toxic leadership practices of managers and turnover intentions. The total effect of toxic leadership behaviour on turnover intention comprised its direct effect (β = 0.238, SE = 0.017, 95% CI [0.205, 0.271]) and its indirect effect (β = -0.020, SE = 0.017).

CONCLUSIONS

Job satisfaction acted as a mediating factor for toxic leadership behaviour and nurses' turnover intentions. As part of nurse retention initiatives, avoiding toxic leadership behaviours will be the ultimate agenda. Nurse administrators should recognize the value of excellent leadership and develop a structured training programme through the use of evidence-based professional development plans for nurse managers.

Career future perceptions and attitudes towards migration of nursing students: A cross-sectional multicenter study

BACKGROUND

It is important to understand the perceptions of career plans and attitudes towards migration of nursing students so that it can be possible to review the education programs in this direction and plan an effective health workforce.

AIM

To determine nursing students' career future perceptions and attitudes towards migration.

DESIGN

Descriptive and cross-sectional online survey.

METHODS

The study was completed with 3053 students from 52 universities located in seven different regions of Turkey who agreed to participate in the study. The data were collected using the "Student Information Form", "Attitude Scale for Brain Drain (ASBD)" and "Career Futures Inventory (CFI)" with an online questionnaire. Descriptive statistics, independent samples t-test, one-way analysis of variance and correlation were used to analyze the data.

RESULTS

Mean age of the students was 20.29 ± 2.28 and most were females. Students' mean total scores of ASBD, and CFI were 56.64 ± 12.22 and 91.32 ± 11.71 respectively. There was a statistically significant difference between the total mean scores of ASBD and the region of the university where the students studied, gender, being multilingual, desire to work abroad after graduation and experience of participating in student exchange programs and between the total mean scores of CFI and experience of participating in an exchange program. There was a positive and statistically significant relationship between ASBD and CFI total mean scores (p < 0.05).

CONCLUSION

Nursing students' attitudes towards migration and perceptions of career future were positive and there was a positive relationship between attitudes towards migration and perceptions of career future.

The imperative of evidence-based health workforce planning and implementation: lessons from nurses and midwives unemployment crisis in Ghana

Following periods of health workforce crisis characterised by a severe shortage of nurses, midwives and doctors due to low production rates and excessive out-migration, the Government of Ghana through the Ministry of Health (MOH) responded by expanding training and allowing private sector involvement in the training of health workers especially nurses and midwives. This resulted in substantial increases in the production levels of nurses and midwives even above the projections of the MOH. In this paper, we discuss how a strategy that was seemingly well planned suffered a decade of uncorrected implementation lapses resulting in a lingering need-based shortage of nurses and midwives at service delivery points whilst thousands of trained nurses and midwives remained unemployed for up to 4 years and constantly protesting for jobs. In the short term, we argue that the Government of Ghana would need to increase investment to recruit trained and unemployed nurses and midwives whilst a comprehensive health labour market analysis is conducted to provide robust evidence towards the development of a long-term health workforce plan that would guide future production of nurses and midwives. The Government of Ghana may also explore the option of a managed migration programme to export nurses/midwives to countries that are already destinations to individual migration initiatives in a bid to mitigate the potential skill loss associated with long periods of unemployment after training, especially for those who trained from the private institutions.

The State of Nursing Research in Ghana: An Integrative Literature Review

INTRODUCTION

For nursing practice to be responsive to the needs of patients, it must be driven by contextual research evidence. To guide institutional and national nursing research policy, there is need to determine the quantity and quality of nursing research in Ghana.

PURPOSE

The purpose of this integrative literature review was to quantify, critically evaluate, and describe nursing research publication in Ghana from January 2007 to December 2016 with regard to the country's research capacity to sustain evidence-based practice.

RESULTS

Sixty (60) out of 749 articles identified from EBSCOhost, ProQuest, PubMed, Science Direct, Scopus, Wiley Online Library, and Google Scholar using three keywords (nursing, health, and Ghana) were included. A total of 60,778 human subjects were used in these studies. There were more quantitative (28) studies than qualitative (23) studies. These studies recorded 219 authors from 120 institutions, 55 of which were outside Ghana. Forty-five percent of the articles were published in journals with impact factor. There was a steady increase in publication in Ghana over the decade. A majority of the studies published in education were in curriculum implementation and evaluation.

CONCLUSIONS

The increasing number of peer-reviewed nursing research publications in Ghana and the curriculum implementation and evaluation in Ghana signified an increasing capacity of the country to implement and sustain evidence-based practice.

RECOMMENDATIONS

It is recommended that regular research be conducted to evaluate the responsiveness to old and new nursing programs in Ghana.

Exploring migration intention of nursing students in Nepal: A mixed-methods study

The objective of this study was to assess the migration intention of students enrolled in pre-registration nursing programs in Nepal, and to explore factors influencing this intention. Using an embedded mixed methods design, 799 nursing students were surveyed, followed by 12 semi-structured face-to-face interviews. The result showed that the majority (92.5%) expressed some intention to migrate, with three quarters of these listed furthering their study abroad as the primary reason. In the multiple regression analysis, those with lower professional identity, and those who reported nursing was not their first choice were likely to express migration intention. Interview data identified low salaries, unemployment, poor working conditions, insufficient postgraduate education, and a lack of professional autonomy in Nepal as reasons for their intention to migrate. Increasing opportunities for nurses to undertake postgraduate education in Nepal, promoting a positive image of nursing, and facilitating a supportive learning environment during undergraduate nursing education could help address the potential loss of nurses from Nepal.