Feature
Does Perceived HIV Stigma Contribute to Nurses' Intent to Migrate in Five African Countries?

https://doi.org/10.1016/j.jana.2009.09.004Get rights and content

Nurse migration out of low-resource countries has occurred for many years, resulting in workforce shortages, particularly in countries with a high prevalence of HIV. A cross-sectional survey of 1,374 nurses from five African countries (Lesotho, Malawi, South Africa, Swaziland, and Tanzania) was conducted. A logistic regression analysis resulted in a profile of odds ratios predicting increased odds of intent to migrate for nurses who were more experienced and working in urban hospitals. These data provide the first support that HIV stigma experienced by nurses through their association as providers for people living with HIV may also be contributing to their intent to migrate. The study contributes to a greater understanding of the complexity of nurse migration in Africa.

Section snippets

Nurse Migration

The World Health Organization (WHO, 2006) has United Nations nurses trained in Africa currently works outside of her or his home country, mainly in 30 industrialized countries. Migratory trends of nurses from low-resource countries to fill staffing needs in high-income countries is well documented (Kingma, 2006). Kingma described nursing as a mobile profession, with reasons for migration varying from better paying jobs to better working conditions to career mobility as well as the simple desire

Design

This study used a cross-sectional, descriptive, survey design. The questionnaires were self-administered by the participating nurses. All the measures were self-reported by participants.

Setting and Sample

Participants were recruited in 2005 through convenience sampling methods in each of the five countries. In Malawi, the participating nurses were from the city of Lilongwe. In South Africa, nurses were recruited in Potchefstroom, an urban area, and Kayakulu, a rural area. In Tanzania, the participating nurses

Results

Data were collected from 1,374 nurses in five countries including Lesotho (n = 281), Malawi (n = 288), South Africa (n = 231), Swaziland (n = 288), and Tanzania (n = 286). Of those nurses, 37% reported that they were considering migrating (See Table 2). There were significant differences between the countries. About 58% of the nurses from Lesotho reported that they planned to leave the country, whereas only 18.6% of the nurses from South Africa reported intent to migrate. This reporting of country-level

Discussion

Conventional migration literature supports the contention that individuals migrate primarily to exploit wage differentials. When the costs of migration are offset by expected higher wages, migration occurs. Although this result may be true for nurses, the authors' data suggest that other factors are also operating in the nurses' intent to migrate in these five African countries. Buchan and Sochalski's (2004) work suggested that nurses seek opportunities for improved professional development as

Disclosures

This work was supported by NIH Research Grant #R01 TW06395 funded by the Fogarty International Center, the National Institute of Mental Health, and the Health Resources and Services Administration, U.S. Government.

Thecla W. Kohi, RN, RM, PhD, is senior lecturer, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

References (35)

  • M. Greeff et al.

    The meaning and effect of HIV/AIDS stigma for people living with AIDS and nurses involved in their care in the North West Province, South Africa

    Curationis

    (2007)
  • M. Greeff et al.

    Disclosure of HIV status: Experiences and perceptions of persons living with HIV/AIDS and nurses involved in their care in Africa

    Qualitative Health Research

    (2008)
  • Greeff, M., Phetlhu, D.R., Makoae, L.N., Dlamini, P.S., Holzemer, W.L., Naidoo, J., et al. (in press). Disclosure of...
  • M. Greeff et al.

    Experiences of HIV/AIDS stigma of PLWA and nurses from five African countries

    African Journal of AIDS Research

    (2008)
  • A. Hagopian

    Recruiting primary care physicians from abroad: Is poaching from low-income countries morally defensible?

    Annals of Family Medicine

    (2007)
  • W.L. Holzemer et al.

    Managing AIDS stigma

    Journal of Social Aspects of HIV/AIDS

    (2004)
  • W.L. Holzemer et al.

    Validation of the HIV/AIDS Stigma Instrument - PLWA (HASI-P)

    AIDS Care

    (2007)

    • Cited by (21)

    • Korean nursing students' intention to migrate abroad

      2013, Nurse Education Today
      Citation Excerpt :

      Fewer nursing students (9%) reported that they would want to migrate because of the political/economic/social instability in South Korea. In other countries, nurses report migrating because of political instability, war, the threat of violence in the workplace and a high crime rate or the prevalence of HIV as in Africa (Kohi et al., 2010). Instead of economic reasons, some of the subjects were concerned about political instabilities, such as the possibility of an outbreak of war between South and North Korea.

    • The Role of the Nurse in Implementation of an HIV Treatment Program in Rural Lesotho

      2012, Journal of the Association of Nurses in AIDS Care

    • Courtesy Stigma and HIV Professionals: A Brief Review of Implications for Psychosocial and Professional Well-Being

      2024, Social Work in Public Health

    • Drivers of health workers' migration, intention to migrate and non-migration from low/middle-income countries, 1970-2022: A systematic review

      2023, BMJ Global Health

    • A Review of the State of the Science of HIV and Stigma: Context, Conceptualization, Measurement, Interventions, Gaps, and Future Priorities

      2021, Journal of the Association of Nurses in AIDS Care

    • Success Stories: Overcoming Barriers to Research in Southern and Eastern African Countries

      2017, Clinical Nursing Research
    View all citing articles on Scopus

    Thecla W. Kohi, RN, RM, PhD, is senior lecturer, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

    Carmen J. Portillo, RN, PhD, FAAN, is professor, University of California, San Francisco.

    Kevin Durrheim, PhD, is professor, University of KwaZulu-Natal, School of Psychology, Scottsville, South Africa.

    Priscilla S. Dlamini, RN, RM, PhD, is senior lecturer, Faculty of Health Sciences, University of Swaziland, Mbabane, Swaziland.

    Lucy N. Makoae, RN, RM, PhD, is lecturer, National University of Lesotho, Maseru, Lesotho.

    Minrie Greeff, RN, RM, PhD, is professor, North-West University, Potchefstroom Campus, Potchefstroom, South Africa.

    Maureen Chirwa, RN, RM, PhD, is senior lecturer, Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi.

    Joanne Naidoo, RN, RM, MS, is lecturer, University of KwaZulu-Natal, School of Nursing, Durban, South Africa.

    Leana R. Uys, RN, RM, DSocSc, is professor, University of KwaZulu-Natal, School of Nursing, Durban, South Africa.

    William L. Holzemer, RN, PhD, FAAN, is professor, University of California, San Francisco.

    View full text
    Copyright © 2010 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.